Rapidly progressive organizing pneumonia associated with COVID-19

Horii, Hiroshi; Kamada, Keisuke; Nakakubo, Sho; Yamashita, Yu; Nakamura, Junichi; Nasuhara, Yasuyuki; Konno, Satoshi

doi:10.1016/j.rmcr.2020.101295

Cited by 13 publications

(21 citation statements)

References 12 publications

(9 reference statements)

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“… Treatment: Both patients received antiviral therapy. [Both survived] Horii et al 83 November 2020, Japan (70, Female) Radiological: Admission chest CT showed bilateral GGOs superimposed with interlobular reticulations and crazy-paving pattern that worsen on day 10 but improved on day 17. Treatment: Favipiravir, ciclesonide, nafamostat for 5-7 days but no improvement so oral prednisolone on day 13 with tapering regimen over 3 months.…”

Section: Methodsmentioning

confidence: 99%

Does COVID-19 pneumonia signify secondary organizing pneumonia?: A narrative review comparing the similarities between these two distinct entities

2021

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Multiple observational studies have described the similarities between COVID-19 pneumonia and organizing pneumonia (OP). These two entities clinically manifest with mild and subacute respiratory symptoms, often with a delayed diagnosis due to the atypical ARDS and silent hypoxemia presentation. Radiological features are often indistinguishable between the two. With the increase in antemortem lung biopsies and autopsies being performed, more histopathological findings of OP and its variant, acute fibrinous and organizing pneumonia (AFOP), are being diagnosed. These entities are known complications of viral infections as a delayed immunological process, explaining the favorable response to corticosteroids. Clinicians should be vigilant to diagnose this under-recognized entity of secondary OP in people with COVID-19 when clinical deterioration occurs, especially with compatible radiologic findings and recent cessation of corticosteroids. Despite the proven benefits of corticosteroids in treating COVID-19, treatment approaches can be more effective as OP often requires higher doses and a more prolonged therapy duration for remission and preventing relapses. The purpose of our narrative review is to compare the similarities between COVID-19 pneumonia and OP, emphasizing the clinical, radiological, and histopathological features based on the evidence available in the literature.

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Section: Methodsmentioning

confidence: 99%

Does COVID-19 pneumonia signify secondary organizing pneumonia?: A narrative review comparing the similarities between these two distinct entities

2021

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“…1 study was found by manually searching ( Zeng et al, 2020 ).Of these, 1 meeting abstract, 2 not written in the English language, 40 not relevant, 2 reviews were excluded. The full text of 33 remained studies was assessed for eligibility and 12 case reports or case series ( Horii et al, 2020 ; Inoue et al, 2020 ; Ito et al, 2020 ; Nakamura et al, 2020 ; Scarpati, 2020 , Shibata et al, 2020 ; Shimazu et al, 2020 ; Zeng et al, 2020a ; Fukada et al, 2021 ; Sumimoto et al, 2021 ; Suzuki et al, 2021 ; Yamaya et al, 2021 ), 2 studies that did not report the results clearly ( Miyagami et al, 2021 ; Takeshita et al, 2021 ), 3 studies that did not classify patients based on disease severity ( Frix et al, 2020 ; Chen et al, 2021a ; Scotto et al, 2021 ) and 1 preprint study ( Alimova et al, 2020 ) were excluded. Finally, 15 studies identified as relevant and entered the quality assessment ( Awano et al, 2020 , d'Alessandro et al, 2020a , d'Alessandro and Cameli, 2020 , d'Alessandro et al, 2020b ; Frix et al, 2020 ; jp, 2020 , Saito et al, 2020 ; Wang et al, 2020 ; Xue et al, 2020 ; Anai et al, 2021 ; Bergantini et al, 2021 ; Chen et al, 2021 , d’Alessandro et al, 2021 ; Deng et al, 2021 ; He et al, 2021 ; Peng et al, 2021 ; Scotto et al, 2021 ).…”

Section: Resultsmentioning

confidence: 99%

Krebs von den Lungen-6 (KL-6) as a clinical marker for severe COVID-19: A systematic review and meta-analyses

Naderi

Rahimzadeh

2022

Virology

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Background Krebs von den Lungen-6 (KL-6) is a molecule that is predominantly expressed by damaged alveolar type II cells, and has been proposed as a marker of COVID-19 and the severity of the disease. Here, we performed a meta-analysis to determine whether KL-6 could be used as a prognostic factor for severe COVID-19. Methods PubMed, Cochrane and Google Scholar were searched until April 20, 2021, and 7 studies were included. KL-6 was considered as the outcome and pooled in meta-analyses. Results All included studies compared KL-6 in severe and non-severe patients. Serum KL-6 was higher in severe COVID-19 patients compared to non-severe (n = 6; SMD = 1.25; 95% CI: 0.99–1.5; P < 0.001) and healthy controls (n = 4; SMD = 3.07; 95% CI: 1.36–4.8; P < 0.001). Conclusion This data collection revealed the potential clinical significance of KL-6 as a non-expensive predictive biomarker in severe COVID-19 and for the categorization of COVID-19 clinical severity.

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“…Although most contraindications are relative under normal circumstances, patients with a young age or failure of no more than one organ should be given priority for ECMO during a pandemic, when supplies and equipment are limited [ 27 ]. ECMO should be considered for SARS-CoV-2-induced SOP in the late phase of infection, since OP-related respiratory failure is usually reversible [ 28 , 29 ]. The introduction of V-V ECMO in patients with COVID-19-related SOP should be further studied, because systemic corticosteroid treatment might fail, as seen in our case.…”

Section: Discussionmentioning

confidence: 99%

“…Yamagishi et al showed that OP with high serum concentrations of SP-D relapsed more frequently than with low SP-D concentrations [ 27 ]. A recent case report by Horii et al identified KL-6 and SP-D as possible biomarkers to evaluate SOP during COVID-19 treatment [ 28 ]. On the other hand, several prognostic biomarkers, including SP-D, have been identified among patients with COVID-19 [ 29 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

Extracorporeal Membrane Oxygenation for Secondary Organizing Pneumonia after Severe SARS-CoV-2 Infection: A Case Report

et al. 2021

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(Background) COVID-19 is caused by SARS-CoV-2 infection and may result in unfavorable outcomes. A recent large-scale study showed that treatment with dexamethasone leads to favorable outcomes in patients with severe COVID-19, and the use of extracorporeal membrane oxygenation (ECMO) has also been shown to improve outcomes. Recently, secondary organizing pneumonia (SOP) has been reported after SARS-CoV-2 infection, but the diagnostic and treatment strategies are still unclear. (Case presentation) Here, we report a patient with severe COVID-19 who developed SOP even after the use of dexamethasone, for whom the introduction of ECMO on the 19th day after hospitalization led to a favorable outcome. (Conclusions) Life-threatening SOP may evolve even after the use of dexamethasone, and the late-phase introduction of ECMO may save such patients with COVID-19.

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Rapidly progressive organizing pneumonia associated with COVID-19

Cited by 13 publications

References 12 publications

Does COVID-19 pneumonia signify secondary organizing pneumonia?: A narrative review comparing the similarities between these two distinct entities

Does COVID-19 pneumonia signify secondary organizing pneumonia?: A narrative review comparing the similarities between these two distinct entities

Krebs von den Lungen-6 (KL-6) as a clinical marker for severe COVID-19: A systematic review and meta-analyses

Extracorporeal Membrane Oxygenation for Secondary Organizing Pneumonia after Severe SARS-CoV-2 Infection: A Case Report

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