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Vol. 58. Issue 4.
Pages T359 (April 2022)
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Vol. 58. Issue 4.
Pages T359 (April 2022)
Clinical Image
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[Translated article] Multiple Solid Nodules at Post-COVID-19 Follow-Up After Mild Pneumonia
Múltiples nódulos sólidos en el seguimiento post-COVID-19 tras neumonía leve
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Jaume Bordas-Martineza, Belén del Ríob, Maria Molina-Molinaa,
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mariamolinamolina@hotmail.com

Corresponding author.
a Unidad Funcional de Intersticio Pulmonar (UFIP), Departamento de Neumología, Hospital Universitario de Bellvitge, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Universidad de Barcelona, Hospitalet de Llobregat, Barcelona, Spain
b Departamento de Radiología, Hospital Universitario de Bellvitge, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Universidad de Barcelona, Hospitalet de Llobregat, Barcelona, Spain
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Arch Bronconeumol. 2022;58:35910.1016/j.arbres.2021.06.017
Jaume Bordas-Martinez, Belén del Río, Maria Molina-Molina
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Our patient was a 67-year-old man who had quit smoking 25 years previously (cumulative dose: 20 pack-years), with no other significant history. He was admitted for mild COVID-19 pneumonia (oxygen therapy 2–3l/min) and treated with remdesivir and dexamethasone 8mg/day for 10 days, and discharged with a protocolized tapering prednisone regimen. A high-resolution chest CT scan at 2 months (Fig. 1A) showed multiple solid bilateral pulmonary nodules measuring less than 1cm and some atelectasis and fibrosis.

Fig. 1.

High-resolution computed tomography (A) showing multiple pulmonary nodules measuring less than 1cm (black arrows) with partial resolution at 3 months (B).

(0.17MB).

Multiple nodules observed on high-resolution computed tomography in patients with COVID-19 has been described previously.1 However, the delayed appearance of multiple solid nodules of mild COVID-19 pneumonias without other inflammatory findings is atypical, and requires a differential diagnosis with neoproliferative and infectious processes. However, due to the patient's satisfactory clinical recovery and lack of reason for concern, we decided to prescribe prednisone 5mg/day and repeat a high-resolution chest CT scan at 3 months (Fig. 1B), which showed progressive resolution of nodules. Although no pathology study was available, given the radiological progress and the clinical context, the diagnosis was organizing foci, which is an uncommon radiological presentation of organizing pneumonia.2

Funding

Research grants from ISCIII, PI21/01287 (co-funded by the European Regional Development Fund, EDF, a way to build Europe).

References
[1]
X. Han, Y. Fan, O. Alwalid, N. Li, X. Jia, M. Yuan, et al.
Six-month follow-up chest CT findings after severe COVID-19 pneumonia.
Radiology, 299 (2021), pp. E177-E186
[2]
M. Baque-Juston, A. Pellegrin, S. Leroy, C.H. Marquette, B. Padovani.
Organizing pneumonia: What is it? A conceptual approach and pictorial review.
Diagn Interv Imaging, 95 (2014), pp. 771-777
Copyright © 2021. SEPAR
Archivos de Bronconeumología

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