A Case of Idiopathic Pulmonary Fibrosis Diagnosed with Progression Post-COVID-19 Pneumonia

A chest tomography taken after COVID-19 revealed bilateral fibrotic foci areas, and two months later it was seen that they had been precursors to honeycomb lesions, and that the usual interstitial pneumonia (UIP) pattern associated with post-COVID pneumonia had occurred. It was noted that the fibrotic lesions in the left lung were already present before the disease. The lesions present in the patient, who had dyspnea pre-COVID-19 but had not been diagnosed with ILD, were considered to be UIP precursor lesions that progressed with the increase in fibroblast activity and the triggering of fibrotic pathways in the course of the disease. The patient was thus diagnosed with Idiopathic Pulmonary Fibrosis (IPF). We suggest that if a UIP appearance develops in COVID-19 patients with progressive fibrosis that is not relieved by anti-inflammatory treatments in long-term examinations, the possibility of IPF should be considered, and so the clinical and radiological findings of patients’ pre-COVID-19 should be investigated for the early identification of IPF.

COVÝD-19 Pnömonisi Sonrasý Progresyon ile Taný Alan Ýdiopatik Pulmoner Fibrozis Olgusu

Hastanýn COVÝD-19 geçirdikten sonraki akciðer tomografisinde bilateral fibrotik odaklar mevcuttu. Ýki ay sonraki baþvurusu tomografisi ile karþýlaþtýrýldýðýnda fibrotik odaklarýn bal peteði lezyonlarýn öncülü olduðu ve COVÝD pnömonisi sonrasý olaðan interstisyel pnömoni (UÝP) paterninin meydana geldiði görüldü. COVÝD-19 öncesi dispnesi olan ancak interstisyel akciðer hastalýðý tanýsý almayan hastada mevcut lezyonlarýn UÝP öncü lezyonlarý olduðu ve hastalýk döneminde fibroblast aktivitesinin artýþý ve fibrotik yolaklarýn tetiklenmesi ile beraber progresyon gösterdiði düþünüldü. Hasta idiopatik pulmoner fibrozis (IPF) olgusu olarak deðerlendirildi. Uzun dönem kontrollerde antiinflamatuvar tedaviler ile rahatlamayan ilerleyici fibrozis saptanan COVÝD-19 hastalarýnda eðer UIP görünümü geliþmiþ ise mutlaka ÝPF olasýlýðýnýn düþünülmesini ve bu yönü ile hastalarýn COVÝD-19 öncesi klinik ve radyolojik bulgularýnýn erken IPF açýsýndan araþtýrýlmasýný öneriyoruz.