Multiple small pneumatoceles as a complication of a SARS-CoV-2 infection in a child from Myanmar

Abstract

During the COVID-19 pandemic, pneumatoceles caused by 2019-nCoV are easily neglected, particularly in children. Which may potentially increase the risk of pneumothorax and pulmonary infection, we need to pay special attention to the management of population migration, especially for children.

Biofilms possibly harbor occult SARS-CoV-2 may explain lung cavity, re-positive and long-term positive results

“…There are increasing cases of COVID-19 patients with cavitary lung lesions, re-positive or long-term positive nucleic acid tests (Chen et al, 2020a;He et al, 2020;Qiao et al, 2020;Selvaraj and Dapaah-Afriyie, 2020;Lu et al, 2020a;Lu et al, 2020a;Wang et al, 2020b;Aggarwal et al, 2021;Afrazi et al, 2021;Chen et al, 2021;Egoryan et al, 2021;Jafari et al, 2021;Liang et al, 2021;Ozgur and Dogan, 2021;Wu et al, 2021;Zhu et al, 2021;Zoumot et al, 2021;He et al, 2022;Maccio et al, 2022). Lung cavities appear at a long-time interval from initial novel coronavirus infection, generally during the absorption phase of the disease, may have severer symptoms after initial recovery and also an increasing mortality rate (Aggarwal et al, 2021;Chen et al, 2021;Egoryan et al, 2021;He et al, 2022;Zoumot et al, 2021). Maccio et al performed autopsies on 35 COVID-19 patients and found that patients could still show diffuse alveolar damage 2 months after the initial diagnosis of COVID-19 (Maccio et al, 2022).…”

“…Thus, being a potential factor in the formation of cystic or cavitary pulmonary lesion (Cardinal-Fernandez et al, 2017). But the existence of some mild COVID-19 cases with cystic or cavitary lung lesions relatively increases the possibility of SARS-CoV-2 directed lung lesions for the low chance of ARDS in mild cases (Chen et al, 2021;He et al, 2022). Some COVID-19 patients had an elevated level of inflammatory cytokines and biomarkers associated with bacterial co-infection (Mirzaei et al, 2020).…”

“…Cavitary or cystic lung lesions in COVID-19 patients may be the result of direct SARS-CoV-2 infection, co-infection with bacterial, fungal or mycobacterial pathogens, secondary to co-existing interstitial lung lesions, cystic bronchiectasis, or barotrauma related to mechanical ventilation, malignancy or metastasis ( Aggarwal et al., 2021 ). COVID-19 patient complicated with pulmonary cavities has a wide age span, including infant, child, adult and elderly patient ( Chen et al., 2021 ; Egoryan et al., 2021 ; Ozgur and Dogan, 2021 ; Zoumot et al., 2021 ; He et al., 2022 ), can appear in both severe and mild COVID-19 ( Selvaraj and Dapaah-Afriyie, 2020 ; Chen et al., 2020a ; Afrazi et al., 2021 ; Aggarwal et al., 2021 ; Chen et al., 2021 ; Jafari et al., 2021 ; Zoumot et al., 2021 ; Kalenchic et al., 2022 ). Some scholars consider lung cavity formation as a late complication during COVID-19 recovery ( Zoumot et al., 2021 ; Egoryan et al., 2021 ).…”

“…However, whether pulmonary cavity is related to the presence of SARS-CoV-2 and the mechanism of occurrence still remain unclear. Besides, the number of patients with long-term positive nucleic acid tests or re-positive results during COVID-19 convalescence period has soared ( He et al., 2020 ; Lu et al., 2020a ; Wang et al., 2020b ; Qiao et al., 2020 ; Lu et al., 2020a ; Liang et al., 2021 ; Wu et al., 2021 ; Zhu et al., 2021 ; He et al., 2022 ; Maccio et al., 2022 ). The source of SARS-CoV-2 and the mechanism of re-positive have not been clarified either.…”