Case Report: Bullous Lung Disease Following COVID-19

Abstract

More than 87% of patients report the persistence of at least one symptom after recovery from the Coronavirus disease 2019 (COVID-19). Dyspnea is one of the most frequently reported symptoms following severe acute respiratory syndrome coronavirus-2 (SARS CoV-2) infection with persistent chest radiological abnormalities up to 3 months after symptom onset. These radiological abnormalities are variable and most commonly include ground-glass opacities, reticulations, mosaic attenuation, parenchymal bands, interlobular septal thickening, bronchiectasis, and fibrotic-like changes. However, in this case report, we describe findings of bullous lung disease as a complication of SARS CoV-2 infection. As the pandemic continues, there is a need to understand the multiple respiratory manifestations of post-acute sequelae of COVID-19. We, therefore, present this case to add to the current body of literature describing pulmonary disease as a consequence of SARS CoV-2 infection.

Keywords: COVID-19; SARS CoV-2; bullous lung disease; post-COVID “Long Haulers”; post-acute COVID-19.

Figure 1

Representative CT images of the chest. (A) During acute COVID-19 infection, CT chest with intravenous (IV) contrast revealed diffuse ground glass with consolidative changes and no evidence of bullous lung disease (BLD). (B) Three-month post-infection, a repeat CT chest with IV contrast showed right-sided bullous lesions with mediastinal shift. (C) The right lower lobe lung section stained with Elastic Van Gieson (EVG) was used to identify the pleural elastic membrane (arrow) to confirm the presence of the bullae (star) localized within the lung parenchyma.