We read the recent article published in KJR titled “Prediction of the Development of Pulmonary Fibrosis Using Serial Thin-Section CT and Clinical Features in Patients Discharged after Treatment for COVID-19 Pneumonia” with great interest (1). The authors assessed the predictors of pulmonary fibrosis using clinical data and followup chest computed tomography (CT) in patients with coronavirus disease (COVID-19) pneumonia (1). The most common CT findings in COVID-19 pneumonia have been described as ground-glass opacities (GGOs) with or without consolidation, crazy-paving pattern, interstitial thickening, irregular interface, and parenchymal band mainly bilateral and lower lobes predilection with peripheral locations (1). Authors found evidence of fibrosis, i.e., irregular interface and parenchymal bands, in nearly half of the patients on initial CT, and in about 85–92% of the patients on followup CT, and they speculated that interstitial thickening, irregular interface, coarse reticular pattern and parenchymal band, manifesting in the process of the disease, might be predictors of pulmonary fibrosis in patients who recovered from COVID-19 pneumonia (1, 2). An irregular interface and parenchymal band might be two early predictors of pulmonary fibrosis (1). From the clinical point of view, fibrosis can be usually seen in elderly patients with severe clinical conditions, especially in patients with higher level of C-reactive protein and interleukin-6 (1). We are not sure whether the authors detected typical pulmonary fibrosis and honeycomb appearances during the follow-up of COVID-19 patients. We encountered a typical pulmonary fibrosis during the follow-up of one COVID-19 patient, whose initial CT examination showed only GGO. Interstitial thickening, irregular interface, or parenchymal bands were not detected on initial CT examination.
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