Pulmonary Cavity: An Additional Entity to the Spectrum of COVID-19 Complications

Abstract

The latest pandemic caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is known to manifest in various forms, ranging from a mild illness to a life-threatening condition. Though lung cavitation has not been commonly reported as a post Coronavirus Disease-2019 (COVID-19) infection complication, there has been a rise in the number of patients presenting with lung cavitation post the viral infection. In this case series, authors have reported four cases of lung cavitation developed post COVID-19 infection. Three out of four patients were newly diagnosed cases of diabetes, all received steroids as a part of treatment for COVID-19 infection. Three patients showed a temporary improvement in their condition after COVID-19 treatment, in the form of decreasing trends of inflammatory markers and decreased total count, but subsequently developed signs of super added infection during the course of their illness. Two patients had associated sino-orbital mucormycosis. Two patients required the support of non invasive ventilation and did not show clinical improvement, while one amongst the two succumbed to the infection. The cause for the development of lung cavities post COVID-19 infection is difficult to speculate it appears to be multifactorial with factors including isolated bacterial, fungal infections or bacterial and fungal co-infection, SARS-CoV-2 specific inflammatory pathways, and the immunosuppressive effects of glucocorticoids.

Keywords

• coronavirus disease-2019
• co-infection
• fungal infections
• mucormycosis
• steroids