Secondary Organizing Pneumonia After Recovery of Mild COVID-19 Infection.

Golbets, Evgeny; Kaplan, Alon; Shafat, Tali; Yagel, Yael; Jotkowitz, Alan; Awesat, Jenan; Barski, Leonid

A 36-year-old male with diffuse large B-cell lymphoma on maintenance rituximab therapy presented to the emergency department with high fever and fatigue. A chest x-ray showed a lobar infiltrate, forty days before admission the patient suffered from a mild COVID-19 infection and fully recovered. PCR nasopharyngeal swab was negative for COVID-19. Comprehensive biochemical, radiological, and pathological evaluation including 18-Fluorodeoxyglucose (FDG) positron emission tomography (PET) with computed tomography (CT) and transbronchial lung biopsy found no pathogen or lymphoma recurrence. Treatment for pneumonia with antibiotic and antifungal agents was non-beneficial. A diagnosis of secondary organizing pneumonia was made after pneumonia migration and a rapid response to corticosteroids. Organizing pneumonia secondary to a viral respiratory infection has been well described. Raising awareness for post-COVID-19 organizing pneumonia has therapeutic and prognostic importance because those patients benefit from steroid therapy. We believe the condition described here is underdiagnosed and undertreated by doctors worldwide. Because of the ongoing global pandemic we are now encountering a new kind of patient, patients that have recovered from COVID-19. We hope that this case may contribute to gaining more knowledge about this growing patient population. This article is protected by copyright. All rights reserved.