4.5 Review

Lung recovery with prolonged ECMO following fibrotic COVID-19 acute respiratory distress syndrome

Journal

AMERICAN JOURNAL OF THE MEDICAL SCIENCES
Volume 365, Issue 3, Pages 307-312

Publisher

ELSEVIER SCIENCE INC

Keywords

COVID-19; Pulmonary fibrosis; ARDS; ECMO

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This article presents a case study of a COVID-19 patient with severe ARDS who required prolonged extracorporeal oxygenation and recovered lung function without lung transplantation. The patient also experienced severe pulmonary fibrosis but eventually resolved after several months of hospitalization. The article also provides a review on post-COVID-19 pulmonary fibrosis.
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus has been associated with acute respiratory distress syndrome (ARDS) and in some cases with pulmonary fibrosis. There is limited information regarding the long-term outcomes of patients who develop severe COVID-19 infection and subsequent pulmonary fibrosis. We present a patient with severe ARDS due to COVID-19 who required prolonged extra-corporeal oxygenation support and eventually recovered significant lung function. This case is unique because the patient survived one of the longest reported runs on extra-corporeal membrane oxygenation without requiring lung transplantation. Further, our patient developed severe parenchymal and airway distortion but ultimately resolved pulmonary fibrosis many months into the hospitalization. In addition to our detailed case discussion, we will provide a focused review on pulmonary fibrosis post COVID-19.

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