Perpetually Positive: Post-COVID Interstitial Lung Disease in an Immunocompromised Patient With Diffuse Large B-cell Lymphoma

Abstract

As more patients recover from COVID-19 infection, long-term complications are beginning to arise. Our case report will explore a debilitating long-term complication, Post-COVID Interstitial Lung Disease (PC-ILD). We will introduce a patient who developed PC-ILD in the setting of diffuse large B-cell lymphoma, outlining a difficult hospital course, including a positive COVID-19 polymerase chain reaction (PCR) for more than 3 months. We will then discuss the human body’s physiological response to the virus and how our patient was not able to adequately mount an immune response. Finally, the pathophysiology of PC-ILD will be explored and correlated with the patient’s subsequent computed tomographic images obtained over a 3-month period. The difficult hospital course and complex medical decision-making outlined in this case report serve as a reminder for health care providers to maintain vigilance in protecting our most vulnerable patient population from such a devastating disease process.

A Systematic Review of Chest Imaging Findings in Long COVID Patients

“…Frequency of lung imaging abnormalities per different evaluation setting. References [ 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 ] are cited in the Supplementary Materials…”

Subtle structural differences of nucleotide analogs may impact SARS-CoV-2 RNA-dependent RNA polymerase and exoribonuclease activity

“…The ultimate cause of this pathology remains an open issue, and different ideas have been posited as its main contributors, including the formation and deposition of blood clots, alterations in the immune system, the persistence of replicating virus in various tissues including the intestinal epithelium, or a combination of all of them [62] , [63] , [64] , [65] . A related, but slightly different scenario, is represented by immunocompromised patients, in which the virus continues its replication for months [66] , [67] . One of the consequences of the prolonged viral replication is the inevitable intra-host SARS-CoV-2 evolution.…”