A Case of Severe Post Covid-19 Pulmonary Fibrosis In A Patient From Milagro, Ecuador

• Jennifer Rodas Pazmiño Clinical and Microbiological Laboratory
• Betty Pazmiño State University of Milagro, Guayas
• Arturo Jaramillo Calko Medical Center
• Andrea Acosta Hospital General de Agudos Bernardino
• Luis Acosta Hospital General del Norte de Guayaquil IESS Ceibos
• María Vallejo Centro de Salud la Guayas
• Andrés Beltrán Centro de Salud Yurima

DOI: https://doi.org/10.5281/zenodo.13173657

Keywords: MeSH, Bronchodilator Agents, COVID- 19, Pulmonary Fibrosis, Smokers, tocilizumab

Abstract

This novel coronavirus SARS-CoV-2, with a rapid spread causing the COVID-19 disease and deaths worldwide. This report focus on a COVID-19 survivor whom develops pulmonary fibrosis, patient of a 66-years-old man with comorbidities and risk factors, developed fever, poorly productive cough, general discomfort, dyspnea, he had no history of travel abroad, chest computed tomography (CT) scan showed bilateral interstitial pneumonia SARS-CoV-2 was identified on nasopharyngeal swab. Case Report: A 66-years-old man from Milagro city, Ecuador with a record of diabetes mellitus II since 3 years ago in treatment with janumet, chronic obstructive pulmonary disease (COPD), chronic smoker pack year 125, developed fever, poorly productive cough, general discomfort, dyspnea, he had no history of travel abroad, chest computed tomography (CT) scan showed bilateral interstitial pneumonia; SARS-CoV-2 was identified on nasopharyngeal swab. Third day of symptoms he arrives at private clinic, with tachypnea, poor ventilatory mechanics using an accessory musculature, SpO2 75% on room air, improves gradually to 94% with supplemental oxygen at 15 litters by non-rebreather mask. The patient received treatment with corticosteroids, anticoagulants, bronchodilators and tocilizumab authorized for emergent use by the (FDA), on second day of hospitalization SpO2 decrease requiring oxygen by high flow cannula fio2: 50% flow 55 liters, during hospitalization improvement was evident, (CT) scan at 18 days follow up showed disease progression with increasing range of ground-glass density patches and consolidation and fibrous interstitial stripes with diagnosis of pulmonary fibrosis y COVID-19 pneumonia. The patient was discharged 28 days after admission, with SpO2 92% with 11 liters of oxygen to continue home handling, the total weaning was achieved after 2 months. Conclusions SARS-CoV-2 has continued infecting millions of people, like previous human coronaviruses, pulmonary fibrosis has been recognized as a potential sequel among survivors. This report focus on a COVID-19 survivor with comorbidities and risk factors whom develop pulmonary fibrosis.

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