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Coronaviruses

Delayed-Onset Organizing Pneumonia: A Perioperative Complication of COVID-19

Strategic Insights

— 1 min read

A study published in the Journal of Surgical Case Reports has highlighted a rare but potentially life-threatening complication of COVID-19, known as delayed-onset organizing pneumonia. Researchers from the Department of Respiratory Medicine at Tokyo Kyosai Hospital in Japan reported a case of a 61-year-old man who underwent left lower lobectomy complicated by persistent air leakage, requiring seven pleurodesis procedures. The patient developed COVID-19 on postoperative Day 10 and initially recovered but was readmitted on Day 27 with fever and respiratory failure.

Key Takeaways:

  • Delayed-onset organizing pneumonia is a rare but serious complication of COVID-19 that can occur in the perioperative setting, especially in patients who have undergone lung resection.
  • The patient's case highlights the importance of extended monitoring in post-lung resection patients with COVID-19 to enable early recognition and prompt intervention of delayed pulmonary complications.
  • The patient's symptoms and radiological findings were characteristic of delayed-onset organizing pneumonia, which is a distinct entity from acute respiratory distress syndrome (ARDS) and acute pulmonary embolism.
  • The use of methylprednisolone pulse therapy showed limited response, which was addressed by adding cyclosporine A, resulting in substantial radiological improvement by postoperative Day 104.
  • The patient's biphasic clinical course, distinctive radiological progression, and limited steroid response led to a diagnosis of delayed-onset organizing pneumonia secondary to post-acute COVID-19 syndrome.
  • The study emphasizes the need for caution and vigilance in managing patients with COVID-19, particularly those with a history of lung resection, to prevent delayed pulmonary complications.
  • The researchers conclude that early recognition and prompt intervention are crucial to prevent progression to life-threatening conditions.

Statistics:

  • The study reports on a single case of delayed-onset organizing pneumonia following perioperative COVID-19 after lobectomy.
  • The patient underwent seven pleurodesis procedures due to persistent air leakage after surgery.
  • The patient's symptoms and radiological findings were evaluated using chest computed tomography, which revealed progressive consolidations with ground-glass opacities.
  • The initial methylprednisolone pulse therapy showed limited response, which was addressed by adding cyclosporine A.
  • The patient achieved substantial radiological improvement by postoperative Day 104.

Sources:

  • NewsRx. Researchers at Department of Respiratory Medicine Report Findings in COVID-19 (Delayed-onset organizing pneumonia following perioperative COVID-19 after lobectomy). Medical Devices & Surgical Technology Week. October 26, 2025; p 181.
  • Katayanagi, S., et al. Delayed-onset organizing pneumonia following perioperative COVID-19 after lobectomy. Journal of Surgical Case Reports, 2025;2025(10).

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