Does COVID-19 pneumonia signify secondary organizing pneumonia?: A narrative review comparing the similarities between these two distinct entities.
Woon H Chong, Biplab K Saha, Amit Chopra
PMID 34098237WHAT IT FOUND
Secondary organizing pneumonia was reported in some hospitalized people with COVID-19, mostly in case reports, series, and autopsies.
Symptoms, CT patterns, and lung tissue findings overlapped with organizing pneumonia, but no tested treatment evidence was available.
Key findings
01Five case reports and three case series described secondary organizing pneumonia diagnosis among hospitalized COVID-19 patients with histopathological confirmation.
02In a radiological study of 165 people with COVID-19, 54.5% (99/165) had a preliminary diagnosis of organizing pneumonia, and organizing pneumonia radiological findings were associated with less ICU admission, invasive mechanical ventilation, mortality, and healing with pulmonary fibrosis than a non-organizing pneumonia pattern.
03In two large post-mortem lung examinations of 100 people with COVID-19, histopathological organizing pneumonia was reported in up to 44% of cases.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a narrative review, not a new patient study, and the authors said the data were too limited and heterogeneous for statistical analysis or high-quality evidence-based recommendations. Most evidence for secondary organizing pneumonia came from case reports, case series, autopsies, and observational studies, so it cannot show that one condition caused the other or that a treatment worked. Organizing pneumonia is rare and may be under-recognized because its clinical and radiological features can resemble COVID-19 pneumonia, and publication bias is likely. Lung biopsies and autopsies were limited during the pandemic, so histopathological confirmation was not available for many presumed cases. The review did not have a single participant count or one study population; it combined studies with different designs, outcomes, and treatment combinations.
Declared interests
No funding was declared, and the authors declared no competing interests.
The easy way to misread this
Do not conclude that COVID-19 pneumonia is usually secondary organizing pneumonia or that corticosteroids improve it. The review relied on case reports, case series, autopsies, and observational studies, and the authors said the data were too limited for high-quality recommendations.