Post COVID pulmonary fibrosis

Case contributed by Mohammad Taghi Niknejad
Diagnosis certain

Presentation

Severe COVID pneumonia about two years ago. Shortness of breath and chronic cough.

Patient Data

Age: 65 years
Gender: Female

Fibrotic changes in both lungs include subpleural reticular opacities, lung architectural distortion, honeycombing and tractional bronchiectasis, which are more prominent at the bases.

Cardiomegaly is present, accompanied by mild pericardial effusion.

Subtle pleural effusion is seen bilaterally.

Degenerative changes such as osteophytes are seen in the thoracic spine.

Case Discussion

Pulmonary fibrosis can be localized, segmental, or lobar or affect the entirety of the lung(s). Post-COVID fibrosis is one of the causes mainly seen in patients admitted to the ICU and needing intubation/ventilation.

On CT, many features can imply underlying pulmonary fibrosis, including honeycombing, traction bronchiectasis, lung architectural distortion, reticulation, and interlobular septal thickening.

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