Follow‐up of two cases of suspected interstitial lung disease following severe COVID‐19 infection shows persistent changes in imaging and lung function

Chérrez-Ojeda, Iván; Robles‐Velasco, Karla; Osorio, María F.; Cottin, Vincent; Centeno, José Vergara; Félix, Miguel

doi:10.1002/ccr3.4918

Cited by 4 publications

(4 citation statements)

References 16 publications

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“…Post-acute COVID-19 syndrome (PACS) is present in more than half of patients, even after 2 years of acute disease [ 1 , 3 , 6 ]. Fatigue and dyspnea are the most common manifestations [ 1 , 7 ]. Current literature has described the most common effects of SARS-CoV-2 on lung structure and function as altered diffusion capacity and restrictive and obstructive patterns [ 6 ]; however, little is known about the role of SAD.…”

Section: Discussionmentioning

confidence: 99%

Small airway disease in post-acute COVID-19 syndrome, a non-conventional approach in three years follow-up of a patient with long COVID: a case report

Cherrez-Ojeda,

Osorio,

Robles-Velasco

et al. 2023

J Med Case Reports

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Background Small airways disease (SAD), a novel finding described in post-acute COVID-19 patients, should be suspected when respiratory symptoms continue, air trapping persists on expiratory CT scans, and imaging findings fail to improve despite objectively better conventional pulmonary function test (PFT) parameters. The forced oscillation technique (FOT) and Multiple breathing washout (MBW) are both very sensitive methods for detecting anomalies in the peripheral airways. Case presentation We discuss the case of a 60-year-old Hispanic patient who had severe COVID-19 pneumonia and developed dyspnea, fatigue, and limited daily activity a year later. The PFTs revealed restrictive lung disease, as seen by significant diffusing capacity of the lungs for carbon monoxide (DLCO) decrease, severe desaturation, and poor 6-min walk test (6MWT) performance. The patient was treated with lowering corticosteroids as well as pulmonary rehabilitation (PR). During the 24-month follow-up, the dyspnea and fatigue persisted. On PFTs, 6MWT performance and restricted pattern improved slightly, but MBW discovered significant ventilatory inhomogeneity. FOT revealed substantial peripheral airway obstructive abnormalities. On CT scans, air trapping and ground-glass opacities (GGO) improved somewhat. The patient used a bronchodilator twice a day and low-dose inhaled corticosteroids (160 µg of budesonide and 4.5 µg of formoterol fumarate dihydrate) for nine months. PR sessions were resuming. The restricting parameters were stabilized and the DLCO had normalized after 36 months, with a 6MWT performance of 87% but significant desaturation. The CT scan revealed traction bronchiectasis, low GGO, and persistent air trapping. Without normalization, FOT and MBW scores improved, indicating small airway disease. Conclusions The necessity of integrating these tests when detecting SAD is emphasized in our paper. This article lays the foundation for future research into the best ways to manage and monitor SAD in post-acute COVID-19 patients.

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Section: Discussionmentioning

confidence: 99%

Small airway disease in post-acute COVID-19 syndrome, a non-conventional approach in three years follow-up of a patient with long COVID: a case report

Cherrez-Ojeda,

Osorio,

Robles-Velasco

et al. 2023

J Med Case Reports

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“…The British Thoracic Society (BTS) guide suggests evaluating patients with severe COVID-19 with full PFTs 12 weeks after hospital discharge [ 62 ]. According to the findings of Cherrez-Ojeda, the impairment in PFTs appears to persist well beyond this timeframe [ 63 ]. A prospective observational study that analyzed the evolution of functional and radiological features between 3 and 6 months after hospital discharge in critical COVID-19 survivors reported the persistence of functional abnormalities such as impairments in total lung capacity (TLC) (41% and 33%) and DLCO (88% and 80%) at the end of the monitoring period [ 64 ].…”

Section: Pulmonary Function Testsmentioning

confidence: 99%

Clinicopathological Outlines of Post-COVID-19 Pulmonary Fibrosis Compared with Idiopathic Pulmonary Fibrosis

et al. 2023

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This review brings together the current knowledge regarding the risk factors and the clinical, radiologic, and histological features of both post-COVID-19 pulmonary fibrosis (PCPF) and idiopathic pulmonary fibrosis (IPF), describing the similarities and the disparities between these two diseases, using numerous databases to identify relevant articles published in English through October 2022. This review would help clinicians, pathologists, and researchers make an accurate diagnosis, which can help identify the group of patients selected for anti-fibrotic therapies and future therapeutic perspectives.

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“…Cherrez et al [7] have reported the follow-up of two cases of pulmonary fibrosis after severe COVID-19 infection. One year later, both cases maintained symptoms of shortness of breath upon exertion and persistence of ground-glass-type opacities, traction bronchiectasis, and interlobular septal thickening that covered much of the lung parenchyma (Figure 1A,B).…”

Section: Pathophysiologymentioning

confidence: 99%

“…However, to our knowledge, there are no prevalence studies of post-COVID-19 pulmonary fibrosis (PCPF) in Latin America. Diagnosis involves persistent respiratory symptoms accompanied by abnormalities in pulmonary function tests and imaging results from serial chest computed tomography [7,8]. No fully proven options are available for the treatment of PCPF.…”

Section: Introductionmentioning

confidence: 99%

Challenges in the Management of Post-COVID-19 Pulmonary Fibrosis for the Latin American Population

Chérrez-Ojeda

Cortés-Télles

Gochicoa‐Rangel

et al. 2022

JPM

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This commentary aims to highlight some of the major issues (with possible solutions) that the Latin American region is currently dealing with in managing post-COVID-19 pulmonary fibrosis. Overall, there is little evidence for successful long-term COVID-19 follow-up treatment. The lack of knowledge regarding proper treatment is exacerbated in Latin America by a general lack of resources devoted to healthcare, and a lack of availability and access to multidisciplinary teams. The discussion suggests that better infrastructure (primarily multicenter cohorts of COVID-19 survivors) and well-designed studies are required to develop scientific knowledge to improve treatment for the increasing prevalence of pulmonary fibrosis in Latin America.

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Follow‐up of two cases of suspected interstitial lung disease following severe COVID‐19 infection shows persistent changes in imaging and lung function

Cited by 4 publications

References 16 publications

Small airway disease in post-acute COVID-19 syndrome, a non-conventional approach in three years follow-up of a patient with long COVID: a case report

Small airway disease in post-acute COVID-19 syndrome, a non-conventional approach in three years follow-up of a patient with long COVID: a case report

Clinicopathological Outlines of Post-COVID-19 Pulmonary Fibrosis Compared with Idiopathic Pulmonary Fibrosis

Challenges in the Management of Post-COVID-19 Pulmonary Fibrosis for the Latin American Population

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