key: cord-0833164-80mvli17
authors: Pogatchnik, Brian P.; Swenson, Kai E.; Sharifi, Husham; Bedi, Harmeet; Berry, Gerald J.; Guo, H. Henry
title: Radiology–Pathology Correlation Demonstrating Organizing Pneumonia in a Patient Who Recovered from COVID-19
date: 2020-08-15
journal: Am J Respir Crit Care Med
DOI: 10.1164/rccm.202004-1278im
sha: 68e4a5670ab6d6aa4c909c905dae6bbe83d6fd45
doc_id: 833164
cord_uid: 80mvli17

nan

The few pathological analyses of coronavirus disease (COVID-19) pneumonia to date, mostly from autopsy studies, report diffuse alveolar damage or acute fibrinous and organizing pneumonia (1) (2) (3) . In contrast, computed tomographic (CT) imaging from numerous patients with COVID-19 includes features more consistent with organizing pneumonia (OP) (4, 5) . A previously healthy 61-year-old woman presented with 3 weeks of dyspnea, cough, and fevers; a nasopharyngeal RT-PCR for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and common respiratory pathogens was negative. CT imaging on Day 3 of admission demonstrated peripheral and basilar patchy opacities with perilobular sparing, consistent with an OP pattern ( Figures 1A and 1B and Video 1). The patient had no signs or symptoms of an underlying rheumatologic condition and took no medications. Two days later, transbronchial biopsies throughout the right lung peripherally revealed scattered fibromyxoid plugs within distal airspaces, indicative of a histologic OP pattern ( Figure 1C recovery. CT imaging 26 days after presentation showed minimal residual opacities ( Figure 1D and Video 2). OP findings in this case may stem from tissue sampling later in a self-limited course of mild to moderate COVID-19. Confirmed radiographically and histologically, OP, as an active and sometimes aberrant lung repair process, may represent the evolution of COVID-19 in patients with mild to moderate disease. n Author disclosures are available with the text of this article at www.atsjournals.org.

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Axial computed tomographic images through the chest without contrast of the patient on hospital Day 3. Video 2. Axial computed tomographic images through the chest without contrast of the patient 26 days after presentation