open access
SARS-CoV-2 lung disease in a patient with pulmonary sarcoidosis — case report
open access
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the recently identified cause of the current pandemic. In patients with chronic respiratory lung diseases, SARS-CoV-2 may result in significant morbidity and increased mortality. We present a case of a 69-year-old male with stage II pulmonary sarcoidosis who had been under observation for 30 months without immunosuppressive treatment. He then developed severe SARS-CoV-2 disease with typical radiological and laboratory findings. Therapy with oxygen, antibiotics, low-molecular-weight heparin in a prophylactic dose, and dexamethasone resulted in marked clinical improvement. We will discuss the rationale for corticosteroid use in both SARS-CoV-2 disease and in SARS-CoV-2 disease that is complicating comorbid sarcoidosis.
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the recently identified cause of the current pandemic. In patients with chronic respiratory lung diseases, SARS-CoV-2 may result in significant morbidity and increased mortality. We present a case of a 69-year-old male with stage II pulmonary sarcoidosis who had been under observation for 30 months without immunosuppressive treatment. He then developed severe SARS-CoV-2 disease with typical radiological and laboratory findings. Therapy with oxygen, antibiotics, low-molecular-weight heparin in a prophylactic dose, and dexamethasone resulted in marked clinical improvement. We will discuss the rationale for corticosteroid use in both SARS-CoV-2 disease and in SARS-CoV-2 disease that is complicating comorbid sarcoidosis.
Keywords
SARS-CoV-2; sarcoidosis; corticosteroids; anticoagulation; computed tomography


Title
SARS-CoV-2 lung disease in a patient with pulmonary sarcoidosis — case report
Journal
Advances in Respiratory Medicine
Issue
Article type
Case report
Pages
620-625
Published online
2020-12-22
DOI
10.5603/ARM.a2020.0199
Pubmed
Bibliographic record
Adv Respir Med 2020;88(6):620-625.
Keywords
SARS-CoV-2
sarcoidosis
corticosteroids
anticoagulation
computed tomography
Authors
Lucyna Magdalena Opoka
Dorota Wyrostkiewicz
Jolanta Winek
Katarzyna Błasińska
Joanna Miłkowska-Dymanowska
Monika Szturmowicz


- Southern BD. Patients with interstitial lung disease and pulmonary sarcoidosis are at high risk for severe illness related to COVID-19. Cleve Clin J Med. 2020 [Epub ahead of print].
- Monpara JD, Sodha SJ, Gupta PK. COVID-19 associated complications and potential therapeutic targets. Eur J Pharmacol. 2020; 886: 173548.
- Jeny F, Lhote R, Lorillon G, et al. Correspondence on 'glucocorticoid-induced relapse of COVID-19 in a patient with sarcoidosis'. Ann Rheum Dis. 2020 [Epub ahead of print].
- Morgenthau AS, Levin MA, Freeman R, et al. Moderate or severe impairment in pulmonary function is associated with mortality in sarcoidosis patients infected with SARS‑CoV‑2. Lung. 2020; 198(5): 771–775.
- Baughman RP, Drent M. The treatment of pulmonary sarcoidosis. In: M.A. Judson (ed). Pulmonary sarcoidosis: a guide for the practicing clinician. Respiratory Medicine 27. Springer Science+Bussiness Media, New York 2014: 41–64.
- Elicker BM, Kallianos KG, Henry TS. The role of high-resolution computed tomography in the follow-up of diffuse lung disease: Number 2 in the Series "Radiology" Edited by Nicola Sverzellati and Sujal Desai. Eur Respir Rev. 2017; 26(144).
- Panselinas E, Judson MA. Acute pulmonary exacerbation of sarcoidosis. In: M.A. Judson (ed). Pulmonary sarcoidosis: a guide for the practicing clinician. Respiratory Medicine 27. Springer Science+Bussiness Media, New York 2014: 65–78.
- Baughman RP, Lower EE. Frequency of acute worsening events in fibrotic pulmonary sarcoidosis patients. Respir Med. 2013; 107(12): 2009–2013.
- Roberto G, Roberta F, Paola BM, et al. Coronavirus disease 2019 (COVID-19) in Italy: features on chest computed tomography using a structured report system. Sci Rep. 2020; 10(1): 17236.
- Fu F, Lou J, Xi D, et al. Chest computed tomography findings of coronavirus disease 2019 (COVID-19) pneumonia. Eur Radiol. 2020; 30(10): 5489–5498.
- Kanne JP, Little BP, Chung JH, et al. Essentials for radiologists on COVID-19: an update- scientific expert panel. Radiology. 2020; 296(2): E113–E114.
- Piazza G, Campia U, Hurwitz S, et al. Registry of arterial and venous thromboembolic complications in patients with COVID-19. J Am Coll Cardiol. 2020; 76(18): 2060–2072.
- Flisiak R, Parczewski M, Horban A, et al. Management of SARS-CoV-2 infection: recommendations of the Polish Association of Epidemiologists and Infectiologists. Annex no. 2 as of October 13, 2020. Pol Arch Intern Med. 2020; 130(10): 915–918.
- Taccone FS, Gevenois PA, Peluso L, et al. Higher intensity thromboprophylaxis regimens and pulmonary embolism in critically ill coronavirus disease 2019 patients. Crit Care Med. 2020; 48(11): e1087–e1090.
- Monreal E, Sainz de la Maza S, Natera-Villalba E, et al. High versus standard doses of corticosteroids in severe COVID-19: a retrospective cohort study. Eur J Clin Microbiol Infect Dis. 2020 [Epub ahead of print].
- Cano EJ, Fuentes XF, Campioli CC, et al. Impact of corticosteroids in coronavirus disease 2019 outcomes: systematic review and meta-analysis. Chest. 2020 [Epub ahead of print].
- Györfi AH, Kopp M, May M, et al. Glucocorticoid-induced relapse of COVID-19 in a patient with sarcoidosis. Ann Rheum Dis. 2020 [Epub ahead of print].
- Sweiss NJ, Korsten P, Syed HJ, et al. When the Game Changes: Guidance to Adjust Sarcoidosis Management During the Coronavirus Disease 2019 Pandemic. Chest. 2020; 158(3): 892–895.