Accelerated Pulmonary Ossification as a Sequela of SARS-CoV-2                    Pneumonia

Moreno, Beatríz García; Weiland, Guadalupe Buitrago; Alegre, Maria Luisa; Rodríguez, Jhon Edilberto Vanegas

doi:10.1148/ryct.2021200598

Cited by 6 publications

(3 citation statements)

References 9 publications

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“…Previous autopsy reports have revealed that the incidence of DPO ranges from 1.6-5.0/1,000 patients (9,10). Case reports of COVID-19 associated with DPO are extremely rare, with only three cases reported in the literature to date (11)(12)(13). TGF-β is produced by inflammatory macrophages and damaged epithelial cells, it promotes fibrosis and stimulates osteoblast proliferation (14).…”

Section: Discussionmentioning

confidence: 99%

An Autopsy Case of COVID-19 with New Diffuse Pulmonary Ossification

Nakagawa,

Kotetsu,

Takizawa

et al. 2024

Intern. Med.

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We present the case of a 61-year-old man who developed Coronavirus disease 2019 (COVID-19) and died during treatment for relapsing polychondritis. The patient was intubated and treated with steroid pulse therapy, remdecivir, antibacterial agents, baricitinib, and tocilizumab. However, his respiratory condition worsened, and he died 108 days after disease onset. An autopsy revealed diffuse alveolar damage in the fibrotic phase in all lung lobes, diffuse pulmonary ossification, and cytomegalovirus-infected cells in the middle lobe of the right lung. We herein discuss the clinical features and pathological findings of COVID-19 in immunosuppressed patients.

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Section: Discussionmentioning

confidence: 99%

An Autopsy Case of COVID-19 with New Diffuse Pulmonary Ossification

Nakagawa,

Kotetsu,

Takizawa

et al. 2024

Intern. Med.

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“…In this case, other etiologies of pulmonary calcification/ossification, such as chronic venous lung congestion or secondary hypercalcemia in end-stage renal disease, were clinically excluded, so that its pathophysiology is likely linked to COVID-19. Only one other case in the literature reported histologically confirmed SARS-CoV-2-associated DPO [ 30 ], making its presentation in COVID-19 patients extraordinarily rare.…”

Section: Discussion/conclusionmentioning

confidence: 99%

Interstitial Pulmonary Fibrosis and Extensive Dendriform Ossification with Persistent Viral Load: A Rare Presentation of Post-COVID-19 Condition in Need of Lung Transplantation

et al. 2022

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The incidence, presentation, and predisposing factors of post-acute sequelae of COVID-19 (PASC) are currently poorly understood. Lung explants may provide a rare insight into terminal SARS-CoV-2-associated lung damage and its pathophysiology. A 62-year-old man presented with progressively worsening respiratory symptoms after recovering from mild COVID-19 3 months earlier. No underlying pulmonary comorbidities were reported. A chest CT revealed bilateral extensive ground-glass and reticular opacities, suspicious of pulmonary fibrosis. Despite initial high-dose glucocorticoid therapy, the interstitial lung disease progressed, and after exhausting all viable therapeutic options, bilateral lung transplantation was successfully conducted. Histological analysis revealed extensive end-stage interstitial fibrosis with diffuse dendriform ossification and bronchiolar and transitional cell metaplasia. Signs of interstitial remodeling such as an increased interstitial collagen deposition, a pathological accumulation of CD163+/CD206+ M2-polarized macrophages with an increased expression of phosphorylated ERK, and an increased density of CD105+ newly formed capillaries were observed. qRT-PCR and immunohistochemistry for SARS-CoV-2 N-protein in the endothelium of medium-sized vessels confirmed a persistence of SARS-CoV-2. Our findings highlight a highly unusual presentation of SARS-CoV-2-associated lung fibrosis, implying that incomplete viral clearance in the vascular compartment may play a vital pathophysiological role in the development of PASC.

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“…[10] Inflammation related calcification of the coronary artery, bronchioles and brain has been reported in patients with symptomatic Covid-19. [4,11,12] The severity of coronary artery calcification has been proposed as a predictor of adverse clinical outcomes in patients with Covid-19, [13] although the actual association between an acute proinflammatory state and tissue calcification has not been confirmed biomedically.…”

Section: Discussionmentioning

confidence: 99%

Diffused bladder wall calcification in a survivor with severe coronavirus disease 2019: A case report

et al. 2022

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Rationale: Bladder calcification is a rare presentation that was first interpreted to be related to a urea-splitting bacterial infection. Aside from infection, other hypotheses such as schistosomiasis, tuberculosis, cancer, and cytokine-induced inflammatory processes have also been reported. Severe coronavirus disease 2019 (COVID-19) is known for its provoking cytokine storm and uninhibited systematic inflammation, and calcification over the coronary artery or lung has been reported as a long-term complication. Patient concerns: We presented a 68 years old man who had persistent lower urinary tract symptoms after recovery from severe COVID-19. No urea-splitting bacteria were identified from urine culture. Diagnosis: Cystoscopy examination revealed diffuse bladder mucosal and submucosa calcification. Interventions: Transurethral removal of the mucosal calcification with lithotripsy. Outcomes: The patient’s lower urinary tract symptoms improved, and stone analysis showed 98% calcium phosphate and 2% calcium oxalate. No newly formed calcifications were found at serial follow-up. Conclusion: Diffuse bladder calcification may be a urinary tract sequela of COVID-19 infection. Patients with de novo lower urinary tract symptoms after severe COVID-19 should be further investigated.

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Accelerated Pulmonary Ossification as a Sequela of SARS-CoV-2 Pneumonia

Cited by 6 publications

References 9 publications

An Autopsy Case of COVID-19 with New Diffuse Pulmonary Ossification

An Autopsy Case of COVID-19 with New Diffuse Pulmonary Ossification

Interstitial Pulmonary Fibrosis and Extensive Dendriform Ossification with Persistent Viral Load: A Rare Presentation of Post-COVID-19 Condition in Need of Lung Transplantation

Diffused bladder wall calcification in a survivor with severe coronavirus disease 2019: A case report

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