Lung Fibrosis due to Coronavirus Disease 2019 Pneumonia with Critical Symptoms: A Case Report

Authors

  • Bintang Yinke Magdalena Sinaga Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Adam Malik Hospital, Medan, Indonesia https://orcid.org/0000-0003-1447-3266
  • Agi Hidjri Tarigan Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Adam Malik Hospital, Medan, Indonesia https://orcid.org/0000-0001-6164-5206

DOI:

https://doi.org/10.3889/oamjms.2022.7830

Keywords:

Acute respiratory distress syndrome, Coronavirus disease 2019, Lung fibrosis

Abstract

BACKGROUND: The pandemic that occurred at the end of 2019 was caused by the coronavirus 2 (Severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]). Various speculations mention that the long-term effects of coronavirus disease 2019 (COVID-19) infection can cause pulmonary fibrosis. Acute respiratory distress syndrome (ARDS) is one that can cause pulmonary fibrosis due to injury to the lungs.

CASE REPORT: This report discusses a case of pulmonary fibrosis caused by critical COVID-19 (Coronavirus disease) in 38-year-old male patient with hypertension and obesity comorbidities. The patient was treated for 51 days in intensive care unit with 60 L/min high flow nasal cannula assisted oxygenation; then his condition improved as evidenced by his negative Real Time - Polymerase Chain Reaction test result, and was subsequently transferred to a non-COVID-19 ward using non-rebreathing mask at 10–15 L/min, which was later titrated to 2–4 L/min nasal canulla. Patient was treated in the non-COVID ward for 16 days. The total number of days of hospitalization was 67 days. Patient had his thorax photo taken 3 times and non-contrast thorax computed tomography (CT) scan 3 times. Based on the evaluation of his thorax CT scan on day 23, we found a vast fibrosis in patient’s lungs. Many literatures state that lung fibrosis can be triggered by ARDS, a condition due to the infection from SARS-CoV-2.

CONCLUSION: COVID-19 infection can progress overtime and may cause pulmonary fibrosis. The most serious phase of this virus infection is characterized by sudden and excessive release of proinflammatory mediators that lead to lung damage with large fibrosis and rapid onset of ARDS. To further our understanding of this issue, we present the case report of lung fibrosis caused by critical COVID-19 infection.

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References

Ojo AS, Balogun SA, Williams OT, Ojo OS. Pulmonary fibrosis in COVID-19 survivors: Predictive factors and risk reduction strategies. Pulm Med. 2020;2020:6175964. https://doi.org/10.1155/2020/6175964 PMid:32850151 DOI: https://doi.org/10.1155/2020/6175964

George PM, Wells AU, Jenkins RG. Pulmonary fibrosis and COVID-19: the potential role for antifibrotic therapy. Lancet Respir Med. 2020;8(8):807-15. https://doi.org/10.1016/S2213-2600(20)30225-3 PMid:32422178 DOI: https://doi.org/10.1016/S2213-2600(20)30225-3

Vitiello A, Pelliccia C, Ferrara F. COVID-19 patients with pulmonary fibrotic tissue: Clinical pharmacological rational of antifibrotic therapy. SN Compr Clin Med. 2020;2(10):1709-12. https://doi.org/10.1007/s42399-020-00487-7 PMid:32875276 DOI: https://doi.org/10.1007/s42399-020-00487-7

Rai DK, Sharma P, Kumar R. Post covid 19 pulmonary fibrosis. Is it real threat? Indian J Tuberc. 2021;68(3):330-3. https://doi.org/10.1016/j.ijtb.2020.11.003 PMid:34099197 DOI: https://doi.org/10.1016/j.ijtb.2020.11.003

Zou JN, Sun L, Wang BR, Zou Y, Xu S, Ding YJ, et al. The characteristics and evolution of pulmonary fibrosis in COVID- 19 patients as assessed by AI-assisted chest HRCT. PLoS One. 2020;16(3):e0248957. https://doi.org/10.1371/journal.pone.0248957 PMid:33755708 DOI: https://doi.org/10.1371/journal.pone.0248957

Selman M, Pardo A. From pulmonary fibrosis to progressive pulmonary fibrosis a lethal pathobiological jump. Am J Physiol. 2020;321:L600-7. https://doi.org/10.1152/AJPLUNG.00310.2021 PMid:34318695 DOI: https://doi.org/10.1152/ajplung.00310.2021

Iqbal FM, Lam K, Sounderajah V, Clarke JM, Ashrafian H, Darzi A. Characteristics and predictors of acute and chronic post-COVID syndrome: A systematic review and meta-analysis. EClinicalMedicine. 2021;36:100899. https://doi.org/10.1016/j.eclinm.2021.100899 DOI: https://doi.org/10.1016/j.eclinm.2021.100899

Nile SH, Nile A, Qiu, J, Li L, Jia X, Kai G. COVID-19: Pathogenesis, cytokine storm and therapeutic potential of interferons. Cytokine Growth Factor Rev. 2020;53:66-70. https://doi.org/10.1016/j.cytogfr.2020.05.002 PMid:32418715 DOI: https://doi.org/10.1016/j.cytogfr.2020.05.002

Yuki K, Fujiogi M, Koutsogiannaki S. COVID-19 pathophysiology: A review. Clin Immunol. 2020;215:108427. https://doi.org/10.1016/j.clim.2020.108427 PMid:32325252 DOI: https://doi.org/10.1016/j.clim.2020.108427

Solomon JJ, Heyman B, Ko JP, Condos R, Lynch DA. CT of post-acute lung complications of COVID-19. Radiology. 2021;301(2):E383-E395. https://doi.org/10.1148/radiol.2021211396 PMid::34374591 DOI: https://doi.org/10.1148/radiol.2021211396

Han X, Fan Y, Alwalid O, Li N, Jia X, Yuan M, et al. Six-month follow-up chest CT findings after severe COVID-19 pneumonia. Radiology. 2021;299(1):E177-86. https://doi.org/10.1148/RADIOL.2021203153 PMid:33497317 DOI: https://doi.org/10.1148/radiol.2021203153

McGroder CF, Zhang D, Choudhury MA, Salvatore MM, D’Souza BM, Hoffman EA, et al. Pulmonary fibrosis 4 months after COVID-19 is associated with severity of illness and blood leucocyte telomere length. Thorax. 2021;76(12):1242-5. https://doi.org/10.1136/thoraxjnl-2021-217031 PMid:33927016 DOI: https://doi.org/10.1136/thoraxjnl-2021-217031

Fernández-De-Las-Penãs C, Palacios-Cenã D, Gómez-Mayordomo V, Palacios-Ceña M, Rodríguez-Jiménez J, de-la-Llave-Rincón AI, et al. Fatigue and dyspnoea as main persistent post-COVID-19 symptoms in previously hospitalized patients: Related functional limitations and disability. Respiration. 2021. https://doi.org/10.1159/000518854 DOI: https://doi.org/10.1159/000518854

Mamun SM A Al, Jahan R, Islam QT, Nazrin T, Shajalal K. Rationale of using common antifibrotic therapy in post covid fibrosis. J Med (Bangladesh). 2021;22(1):46-50. https://doi.org/10.3329/jom.v22i1.51391 DOI: https://doi.org/10.3329/jom.v22i1.51391

Sequelae L, Bari E, Ferrarotti I, Saracino L, Perteghella S, Torre ML, et al. Mesenchymal stromal cell secretome for post-COVID-19 pulmonary fibrosis: A new therapy to treat the long-term lung sequelae? Cells. 2021;10(5):1203. https://doi.org/10.3390/cells10051203 PMid:34068958 DOI: https://doi.org/10.3390/cells10051203

Greenhalgh T, Knight M, A’Court C, Buxton M, Husain L. Management of post-acute covid-19 in primary care. BMJ. 2020;370:m3026. https://doi.org/10.1136/bmj.m3026 PMid:32784198 DOI: https://doi.org/10.1136/bmj.m3026

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Published

2022-01-08

How to Cite

1.
Sinaga BYM, Tarigan AH. Lung Fibrosis due to Coronavirus Disease 2019 Pneumonia with Critical Symptoms: A Case Report. Open Access Maced J Med Sci [Internet]. 2022 Jan. 8 [cited 2024 Apr. 24];10(C):1-5. Available from: https://oamjms.eu/index.php/mjms/article/view/7830

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Case Report in Internal Medicine

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