PMC8458727_01
Chest CT scan of COVID-19 pneumonia (first chest CT scan). Axial sections of the chest CT scan at different levels show bilateral ground-glass opacities and consolidation images that are bilateral, subpleural, and located mainly in posterior regions (A-C).
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F1
The chest CT scan performed on the fifth day of symptom onset showed ground-glass opacities suggestive of COVID-19 with moderate lung involvement (Figure 1).
Follow-up chest CT scan of post-COVID-19 pneumonia (second chest CT scan). The chest CT scan performed 4 weeks after the management of severe COVID-19 pneumonia reveals the appearance of bronchiectasis (A-C; green arrow), subpleural reticulations (F; blue arrow), lobular distortions (F; violet arrow), fissure deformity (C; orange arrow), paracicatricial emphysema (D,E; red arrow), and cavitation in the right middle lobe (D; black arrow).
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F2
The CT scan also showed reticulation and globular distortion, and traction bronchiectasis associated with ground-glass opacities and scissural deformation (Figures 2A-F). A paracicatricial emphysema without honeycomb signs and the appearance of a cavity image in the right middle lobe were also noted (Figures 2D,E). Due to these new radiological images, and to eliminate a superinfection, a bronchoscopy with a bronchioalveolar lavage (BAL) was performed in the right middle lobe where the cavity image was located (Figure 2D).
Post-corticotherapy chest CT scan (third chest CT scan). The chest CT scan performed after 3 months of corticotherapy of post-COVID-19 symptoms reveals the regression of ground-glass lesions and bronchiectasis, and the persistence of paracicatricial emphysema (A-C). (B-D) Show the disappearance of the cavity image of the right middle lobe, the regression of retraction signs, and the persistence of few reticulation lesions.
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F3
Surprisingly, the follow-up chest CT scan at the same period showed a significant and unexpected improvement of the pulmonary lesion characterized by the disappearance of bronchiectasis (Figures 3A-C), the significant reduction of reticulations, and the regression of retraction signs (Figures 3B-D). The CT scan also revealed the disappearance of the cavity image of the right middle lobe (Figure 3C), but the persistence of paracicatricial emphysema (Figures 3B,C).