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Case Report

Organizing Pneumonia and Microvascular Fibrosis as Late Sequelae after a COVID-19 Infection. A Case Report

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Department of Cardiothoracic Surgery, The Erasmus MC University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
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Department of Pathology, The Erasmus MC University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
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Department of Intensive Care Adults, The Erasmus MC University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
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Department of Pulmonary Medicine, The Erasmus MC University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
*
Author to whom correspondence should be addressed.
Academic Editor: Cornelis F. M. Sier
Received: 22 April 2021 / Revised: 14 May 2021 / Accepted: 25 May 2021 / Published: 29 May 2021
We report a patient with COVID-19 requiring hospitalization for two weeks, complicated by multiple segmental pulmonary embolisms for which dabigatran was initiated. After clearing the infection, the patient remained asymptomatic for 5 months. He was then readmitted with a spontaneous haemothorax, most likely related to the use of dabigatran, which progressed to a pleural empyema with a trapped lung. The patient underwent a video assisted thoracoscopy (VATS) with decortication. Because of focal abnormalities, biopsies for histopathology were taken from the lung parenchyma. These showed an organizing pneumonia with progression towards fibrosis and arteries with intimal fibrosis. So far, no histopathological reports exist on late pulmonary changes after a COVID-19 infection. The unusual combined presence of microvascular damage and interstitial fibrosis may reflect a pathophysiological concept in which early endothelial damage by SARS-CoV-2 can lead to a chronic state of microvascular damage, low grade inflammation, and early progression towards pulmonary fibrosis. View Full-Text
Keywords: COVID-19; pulmonary fibrosis; thrombosis; pathology COVID-19; pulmonary fibrosis; thrombosis; pathology
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MDPI and ACS Style

Dikken, J.L.; Maat, A.P.W.M.; Wolf, J.L.; Endeman, H.; Hoek, R.A.S.; Bogers, A.J.J.C.; Mahtab, E.A.F. Organizing Pneumonia and Microvascular Fibrosis as Late Sequelae after a COVID-19 Infection. A Case Report. Surgeries 2021, 2, 190-198. https://0-doi-org.brum.beds.ac.uk/10.3390/surgeries2020020

AMA Style

Dikken JL, Maat APWM, Wolf JL, Endeman H, Hoek RAS, Bogers AJJC, Mahtab EAF. Organizing Pneumonia and Microvascular Fibrosis as Late Sequelae after a COVID-19 Infection. A Case Report. Surgeries. 2021; 2(2):190-198. https://0-doi-org.brum.beds.ac.uk/10.3390/surgeries2020020

Chicago/Turabian Style

Dikken, Johan L., Alexander P.W.M. Maat, Janina L. Wolf, Henrik Endeman, Rogier A.S. Hoek, Ad J.J.C. Bogers, and Edris A.F. Mahtab. 2021. "Organizing Pneumonia and Microvascular Fibrosis as Late Sequelae after a COVID-19 Infection. A Case Report" Surgeries 2, no. 2: 190-198. https://0-doi-org.brum.beds.ac.uk/10.3390/surgeries2020020

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