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- Title
#SEVERECOVID-19: THE TRENDING TRIGGER.
- Authors
Cetină, Diana-Maria; Topor, Alexandru; Zaha, Miruna; Motoc, Nicoleta Ştefania
- Abstract
Introduction: Post-COVID-19 interstitial lung disease (ILD) is known to be a sequellary, organizing form of the interstitial pneumonia, that can sometimes be progressive. Obstructive Sleep Apnea (OSA) is known to be a risk factor for COVID-19 morbidity and short and long-term mortality. Pulmonary Alveolar Proteinosis is an ultra-rare disease in which surfactant components, that impair gas exchange, accumulate in the alveolae, that only have around 500 reported cases in total. Case Report: The following paper presents the case of a 38-year-old female patient who was admitted in our pneumology department for periodic evaluation, accusing mild exertional dyspnea. Medical history revealed obesity (BMI = 40 kg/m2) CT-confirmed Interstitial Lung Disease (ILD) after a severe episode of COVID-19 infection 3 years ago. She underwent a recent diagnosis of Obstructive Sleep Apnea (OSA) under Continuous Positive Air Pressure (CPAP). Spirometry and plethysmography were performed, indicating the aggravation of the restrictive lung disease comparing to the results from the last check-up. As SpO2 levels lowered significantly, ventilatory polygraphy was performed to evaluate OSA, characterizing it as severe and in need for 24h oxygen therapy. CT scan revealed the diffuse pattern of the Non-Specific Interstitial Pneumonia (NSIP), progressing and starting to differentiate from typical, looking more like "crazy-paving" appearence. Lung biopsy indicated secondary Pulmonary Alveolar Proteinosis (PAP), an extremely rare disease, that was treated using whole lung lavage Discussions : No significant association between post-COVID19 ILD and the development or aggravation of OSA has been described previously. The important desaturations could be caused by the advanced apneic disease overlapping the severe ILD. Studies have shown several connections between ILDs and OSA, including the need to step up the treatment options to oxygen therapy and mechanical ventilation. In the case of PAP, only several case reports associated severe COVID-19 history with PAP and none associating PAP and Post-COVID-19 or any other type of ILD. This data can probably indicate that the ILD in this patient may probably never have been ILD, but PAP from the very beginning. Conclusions: This so-called "trending" virus, COVID-19, among its known ILD complication, may precipitate other comorbidities that decrease the patient's life quality and expectancy.
- Subjects
ROMANIA; SLEEP apnea syndrome treatment; LUNG disease treatment; BIOPSY; OXYGEN therapy; COMPUTED tomography; CONFERENCES &; conventions; BRONCHOALVEOLAR lavage; COVID-19
- Publication
Acta Marisiensis. Seria Medica, 2024, Vol 70, p316
- ISSN
2668-7755
- Publication type
Article