Postinfectious Interstitial Pneumonia After COVID-19 Infection

摘要

To the Editor A 62-year old man with diabetes mellitus was hospitalized with 10 days of chest pain, malaise, myalgia, cough, and dyspnea. A nasopharyngeal polymerase chain reaction confirmed COVID-19 and a chest CT scan showed bilateral ground-glass opacities. The patient required 10 L of oxygen by nonrebreather oxygen mask and was treated with ceftriaxone, enoxaparin, ivermectin, and tocilizumab. Forty-eight hours after admission, his respiratory condition deteriorated, requiring prone positioning, methylprednisolone 500 mg IV once and high flow oxygen (FiO_2 = 100%). Seventy-two hours after admission, his respiratory condition was unchanged but his radiological appearance deteriorated. His lymphocyte count was decreased and lactate dehydrogenase, ferritin, and d-dimer worsened. A new dose of tocilizumab and IV methylprednisolone 500 mg for 3 days were administered. Because no evidence of over imposed infection was found, antibiotics were discontinued, and the patient was left on oxygen supplementation and enoxaparin, but the FiO_2 could not be decreased below 50% thereafter.