Radiologically suspected COVID‑19‑associated organizing pneumonia responding well to corticosteroids: A report of two cases and a review of the literature

Siafarikas,Christos; Stafylidis,Christos; Tentolouris,Anastasios; Samara,Stamatia; Eliadi,Irene; Makrodimitri,Sotiria; Spandidos,Demetrios A.; Mathioudakis,Nikolaos; Karamichalos,Panagiotis; Papalexis,Petros; Chlapoutakis,Serafeim; Sklapani,Pagona; Trakas,Nikolaos; Georgakopoulou,Vasiliki Epameinondas

doi:10.3892/etm.2022.11379

Radiologically suspected COVID‑19‑associated organizing pneumonia responding well to corticosteroids: A report of two cases and a review of the literature

Authors:
- Christos Siafarikas
- Christos Stafylidis
- Anastasios Tentolouris
- Stamatia Samara
- Irene Eliadi
- Sotiria Makrodimitri
- Demetrios A. Spandidos
- Nikolaos Mathioudakis
- Panagiotis Karamichalos
- Petros Papalexis
- Serafeim Chlapoutakis
- Pagona Sklapani
- Nikolaos Trakas
- Vasiliki Epameinondas Georgakopoulou
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Affiliations: First Department of Propedeutic and Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece, First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece, First Department of Propedeutic and Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece, Department of Infectious Diseases‑COVID‑19 Unit, Laiko General Hospital, 11527 Athens, Greece, Department of Infectious Diseases‑COVID‑19 Unit, Laiko General Hospital, 11527 Athens, Greece, Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece, Renal Transplantation Unit, Laiko General Hospital, 11527 Athens, Greece, Department of Pathophysiology, Laiko General Hospital, 11527 Athens, Greece, Unit of Endocrinology, First Department of Internal Medicine, Laiko General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece, Department of Thoracic Surgery, Agios Savvas, Hospital, 11522 Athens, Greece, Department of Cytology, Mitera Hospital, 15123 Athens, Greece, Department of Biochemistry, Sismanogleio Hospital, 15126 Athens, Greece
Published online on: May 18, 2022 https://doi.org/10.3892/etm.2022.11379
Article Number: 453
Copyright: © Siafarikas et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Organizing pneumonia (OP) is a type of diffuse interstitial lung disease, which may be induced in the context of several clinical conditions, such as drug reactions, infections, autoimmune diseases and cancer. Coronavirus disease 2019 (COVID‑19)‑associated OP has been reported as a late‑stage consequence of the infection or a histological form of COVID‑19‑associated pneumonia. Autopsies and postmortem lung biopsies have demonstrated that the majority of patients with COVID‑19‑associated pneumonia develop secondary OP, and COVID‑19‑associated pneumonia and OP have common radiological features. The diagnosis of COVID‑19‑associated OP should be suspected in patients with severe acute respiratory syndrome coronavirus 2 infection who exhibit clinical deterioration despite optimal care, or who have aggravating symptoms following an initial recovery. The use of corticosteroids is a typical treatment for OP. However, to date, at least to the best of our knowledge, there are a few reports regarding the role of corticosteroids in COVID‑19‑associated pneumonia; thus, the optimal time for administration, the dose and treatment duration have not yet been determined. The present study presents two cases of patients with COVID‑19, who exhibited clinical deterioration following the initial phase of infection and with radiological characteristics of OP who received corticosteroids and had a favorable outcome. The early diagnosis of COVID‑19‑associated OP may lead to targeted treatment, decreased requirements for ventilatory support and an improved survival rate.

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