[Clinical, radiological, and histopathological features of pulmonary post-COVID syndrome : A form of autoimmune-mediated interstitial lung disease?] / Klinische, radiologische und histopathologische Merkmale des pulmonalen Post-COVID-Syndroms : Eine Form der autoimmunvermittelten interstitiellen Lungenerkrankung?
Pathologe
; 42(Suppl 2): 160-164, 2021 Dec.
Article
em De
| MEDLINE
| ID: mdl-34850268
ABSTRACT
BACKGROUND:
About 10% of patients develop persistent symptoms after mild/moderate COVID-19. We have previously reported detection of antinuclear autoantibodies/extractable nuclear antigens (ANA/ENA) in patients with severe COVID-19.OBJECTIVES:
The aim of this small pilot study was to characterize long-/post-COVID and to evaluate possible similarities between lung involvement in long-/post-COVID and connective tissue disease (CTD).METHODS:
We prospectively enrolled 33 previously healthy patients with persistent pulmonal symptoms after mild/moderate COVID-19 without hospitalization (median age, 39â¯years). We performed clinical evaluation including pulmonary function tests, computed tomography (CT), and serology for ANA/ENA. In 29 of 33 patients, transbronchial biopsies (TBBs) were taken for histopathological assessment.RESULTS:
Most patients presented with disturbed oxygen pulse in spiroergometry and slight lymphocytosis in bronchoalveolar lavage (BAL) fluid. The CT pattern showed bronchial wall thickening and increased low-attenuation volume. Autoantibodies were detected in 13 of 33 patients (39.4%). Histopathological assessment showed interstitial lymphocytosis with alveolar fibrin and organizing pneumonia. Ultrastructural analyses revealed interstitial collagen deposition.CONCLUSION:
While histopathology of pulmonary long-/post-COVID alone is unspecific, the combination with clinical and radiological features together with detection of autoantibodies would allow for a diagnosis of interstitial pneumonia with autoimmune features (IPAF). Since we observe interstitial collagen deposition and since IPAF/CTD-ILD might progress to fibrosis, the persistence of autoantibodies and possible fibrotic change should be closely monitored in autoantibody-positive long-/post-COVID patients.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Doenças Pulmonares Intersticiais
/
COVID-19
Limite:
Adult
/
Humans
Idioma:
De
Ano de publicação:
2021
Tipo de documento:
Article