vestimИзвестия Национальной академии наук Беларуси. Серия медицинских наукProceedings of the National Academy of Sciences of Belarus, Medical series1814-60232524-2350The Republican Unitary Enterprise Publishing House "Belaruskaya Navuka"10.29235/1814-6023-2021-18-4-413-421vestim-799Research ArticleКЛИНИЧЕСКАЯ И ЭКСПЕРИМЕНТАЛЬНАЯ МЕДИЦИНАCLINICAL AND EXPERIMENTAL MEDICINEЛегочный фиброз как исход COVID-19 пневмонииPulmonary fibrosis as an outcome of COVID-19 pneumoniaКаленчицТ. И.KalenchicT. I.

Каленчиц Тамара Ивановна  – канд. мед. наук, доцент

пр. Дзержинского, 83, 220116, г. Минск

Tamara I. Kalenchic – Ph. D.(Med.), Associate Professor

83, Dzerzhinski Ave., 220116, Minsk

kalenchic@gmail.comhttps://orcid.org/0000-0002-7173-1818КабакС. Л.KabakS L.

Кабак Сергей Львович  – д-р мед. наук, профессор

пр. Дзержинского, 83, 220116, г. Минск

Sergey L. Kabak – Ph. D. (Med.), Professor

83, Dzerzhinski Ave., 220116, Minsk

kabakmorph@gmail.comКореневскаяИ. В.KorenevskayaI. V.

Кореневская Инна Валерьевна  – врач-пульмонолог

ул. Уральская, 5, 220037, г. Минск

Inna V. Korenevskaya – pulmonologist

5, Ural’skaya Str., 220037, Minsk

inna.korenevskaya.91@mail.ruБелорусский государственный медицинский университетBelarusian State Medical University6-я городская клиническая больница6th City Clinical Hospital202103122021184413421Copyright © Каленчиц Т.И., Кабак С.Л., Кореневская И.В., 20212021Каленчиц Т.И., Кабак С.Л., Кореневская И.В.Kalenchic T.I., Kabak S.L., Korenevskaya I.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestimed.belnauka.by/jour/article/view/799

В статье проведен анализ данных трех пациентов, у которых в результате перенесенной COVID-19 пневмонии появилась стойкая и сильно выраженная дыхательная недостаточность с рентгенологическими признаками диффузного легочного фиброза. При компьютерной томографии органов грудной клетки признаками фиброза служили тракционные бронхоэктазы и паренхиматозные тяжи, а также многочисленные мелкие субплевральные кистозные воздушные пространства (симптом «сотового легкого»). Во всех случаях факторами риска были мужской пол, пожилой возраст пациентов и мультикоморбидность. У одного из пациентов с острым респираторным дистресс-синдромом рентгенологические признаки легочного фиброза были диагностированы одновременно с типичными проявлениями поражения легочной ткани при COVID-19 пневмонии (симптом «матового стекла»). У двух других пациентов объективные признаки фиброза появились примерно через 2 мес. после пребывания в стационаре.

Таким образом, легочный фиброз ‒ одно из тяжелых и быстро прогрессирующих осложнений COVID-19 пневмонии с неблагоприятным прогнозом, особенно у пациентов с множественными факторами риска.

In this study, we report three cases of persistent  severe respiratory failure and radiological signs of diffuse pulmonary fibrosis in patients after COVID-19 related pneumonia. Chest CT criteria for a diagnosis of pulmonary fibrosis include the presence of traction bronchiectasis and parenchymal bands (linear opacities), as well as numerous small subpleural cystic air spaces (honeycombing). The study found that all cases of fibrosis were associated with such risk factors as male gender, old age, and multicomorbidity. Chest CT of one patient with acute respiratory distress syndrome showed radiographic characteristics of pulmonary fibrosis together with the presence of ground glass opacities (GGO) – the main CT feature of COVID-19 pneumonia. In two other patients, CT features of pulmonary fibrosis appeared in about 2 months after the hospital stay.

Thus, pulmonary fibrosis is severe and rapidly progressive complication of COVID-19 pneumonia with a poor prognosis, especially in patients with multiple risk factors.

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The authors declare that there are no conflicts of interest present.