Lung Fibrosis due to Coronavirus Disease 2019 Pneumonia with Critical Symptoms: A Case Report

Abstract

BACKGROUND: The pandemic that occurred at the end of 2019 was caused by the coronavirus 2 (Severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]). Various speculations mention that the long-term effects of coronavirus disease 2019 (COVID-19) infection can cause pulmonary fibrosis. Acute respiratory distress syndrome (ARDS) is one that can cause pulmonary fibrosis due to injury to the lungs. CASE REPORT: This report discusses a case of pulmonary fibrosis caused by critical COVID-19 (Coronavirus disease) in 38-year-old male patient with hypertension and obesity comorbidities. The patient was treated for 51 days in intensive care unit with 60 L/min high flow nasal cannula assisted oxygenation; then his condition improved as evidenced by his negative Real Time - Polymerase Chain Reaction test result, and was subsequently transferred to a non-COVID-19 ward using non-rebreathing mask at 10–15 L/min, which was later titrated to 2–4 L/min nasal canulla. Patient was treated in the non-COVID ward for 16 days. The total number of days of hospitalization was 67 days. Patient had his thorax photo taken 3 times and non-contrast thorax computed tomography (CT) scan 3 times. Based on the evaluation of his thorax CT scan on day 23, we found a vast fibrosis in patient’s lungs. Many literatures state that lung fibrosis can be triggered by ARDS, a condition due to the infection from SARS-CoV-2. CONCLUSION: COVID-19 infection can progress overtime and may cause pulmonary fibrosis. The most serious phase of this virus infection is characterized by sudden and excessive release of proinflammatory mediators that lead to lung damage with large fibrosis and rapid onset of ARDS. To further our understanding of this issue, we present the case report of lung fibrosis caused by critical COVID-19 infection.