Long COVID Mimicking Interstitial Lung Disease: A Case Series

Abstract

Interstitial lung diseases (ILD) can occur due to various known or unknown causes. They usually present with dry cough and exertional dyspnea. On radiology usual findings are ground glass opacities (GGO's), reticular shadows, nodules etc. Some patients after acute COVID-19 (coronavirus disease 2019) suffer from persistent symptoms/manifestations. These have been called 'Long COVID'. Long COVID also has radiological features like GGO's, nodules and reticulations. Further, patients even without history of acute COVID-19, can also present with 'Long COVID'. In the present case series, we describe three such cases with no history of having suffered from COVID-19, presenting with ILD like features and diagnosed as Long COVID. We infer from these cases that 'Long COVID' can both clinically and radiologically mimic ILD's. Hence, emphasizing the fact that in the present COVID-19 pandemic situation, 'Long COVID should be a differential diagnosis to be considered while making a new diagnosis of ILD.

Keywords: COVID-19 RT-PCR Testing; COVID19; IgG; Interstitial Lung Disease; SARS-CoV-2.

Figure 1

(a), Case 1 Chest X-ray (posteroanterior view) showing bilateral diffuse reticulations; (b), Case 1 showing clearing of reticulations after 7 weeks

Figure 2

(a), Case 1 CT scan of chest showing patchy areas of ground glass opacities. (b), Case 1 showing clearing of ground glass opacities after 7 weeks

Figure 3

(a), Case 2 CT scan of chest showing diffuse ground glass opacities with interstitial thickening; (b), Case 2 showing clearing of ground glass opacities after 10 weeks

Figure 4

(a), Case 3 CT scan of chest showing bilateral lower lobe reticulations; (b), Case 3 showing clearing of reticulations after 12 weeks