Radiologically Undetectable Latent Pulmonary Lymphocyte Infiltration Suggesting the Need for Early Glucocorticoid Therapy: An Autopsy Case of Rapidly Progressive COVID-19 Pneumonia with Lymphopenia

Naoki Tanomogi, Toshinori Otani, Junko Araki, Ayumi Sugitani, Shingo Itagaki, Kiriu Takahiro, Kota Shimada
2021 Internal medicine (Tokyo. 1992)  
We herein report a fatal case of COVID-19 pneumonia with rapid progression of respiratory failure and lymphopenia. Excessive recruitment and sequestration of lymphocytes in the lung were suggested as the pathophysiology underlying COVID-19-associated lymphopenia. Interestingly, the autopsy in this case revealed lymphocytic infiltration in the lungs even at sites that appeared normal on autopsy imaging. These findings suggest that in COVID-19 cases with risk factors of severe exacerbation, early
more » ... glucocorticoid administration should be considered, especially if lymphopenia is present, even if the imaging findings show only mild abnormalities.
doi:10.2169/internalmedicine.7234-21 pmid:33994439 fatcat:2fdd6eu6irdvzo2v6jttvmrdf4