Severe progressive fibrosing interstitial lung disease post COVID 19 infection

ABSTRACT

Background: Majority of COVID 19 patients that are hospitalized are with respiratory illness including pneumonia and ARDS.The acute manifestations of COVID 19 has been well documented however long-term sequelae from acute COVID 19 remain speculative. Chronic lung disease including IPF is a risk factor for poorer prognosis in COVID 19 infection. Case Study A 52-year-old male patient presented to emergency department with history of dyspnea on and off for past 6 months increased over last two days, cough with expectoration for past 2 months. Eight months back he was treated for COVID 19 pneumonia with dexamethasone and maximal oxygen requirement of 2L via nasal cannula. CT chest showed diffuse GGO's in bilateral upper and lower lobes with CT severity score of 20/25. Patient was discharged with no oxygen requirement with saturation of 96% on room air. On arrival to the hospital, patient was tachypneic and in type 1 respiratory failure, requiring 10L of oxygen. CT chest showed honeycombing with consolidation and traction bronchiectasis. Discussion: Advanced fibrosis and poor lung function are associated with severe disease and poorer prognosis in COVID 19 infection. CD 209L receptors has been implied in the pathogenesis of progressive ILD in COVID 19 infection. Conclusion: Early detection of potential cases of post- COVID 19 pulmonary fibrosis may give a chance to prevent or at least modify such disabling complication.