Organizing pneumonia following Covid19 pneumonia

Abstract

The potential mid-term and long-term consequences after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections are as yet unknown. This is the first report of bronchoscopically verified organizing pneumonia as a complication of coronavirus disease 2019 (Covid19). It caused persisting dyspnea, impaired pulmonary function, and radiological abnormalities over 5 weeks after onset of symptoms. While organizing pneumonia frequently requires treatment with systemic corticosteroids, in this case it resolved spontaneously without treatment after 6 weeks. Healthcare professionals should consider organizing pneumonia in patients with persisting respiratory symptoms after Covid19.

Keywords: Fibrosis; Inflammatory lung disease; Interstitial lung disease; Long Covid; Pulmonary infection.

Fig. 1

Posterior-anterior Chest X‑ray from 22 April and 4 May showing substantial spontaneous improvement of the interstitial opacities and reticular densities

Fig. 2

Lung CT scan in the upper lobe 4 weeks after symptom onset showing patchy subpleural ground glass opacities and linear consolidation

Fig. 3

Lung CT scan in the lower lobes showing ground glass, arcade-like bands of parenchymal consolidation, peribronchial consolidation and mild bronchiolectasis

Fig. 4

Lung histology demonstrating micropolypoid buds of pale, myxoid granulation tissue in the alveoli. These granulation areas are known as Masson bodies, protruding into the alveoli and bronchioles (hematoxylin and eosin × 100)