Post-covid transformation of the lungs with the development of pleural empyema

Abstract

This article presents the results of a clinical observation reflecting the changes occurring in the body following COVID-19. The study primarily focuses on severe pulmonary complications associated with post-COVID-19, including acute respiratory distress syndrome (ARDS) and widespread pleuropulmonary injuries. The clinical course, computed tomography (CT) findings, laboratory parameter changes, and histopathological descriptions have been analyzed, providing insights into the systemic effects and pathogenesis of COVID-19-related complications. Findings from chest CT scans revealed bilateral interstitial lung involvement in up to 70% of cases, along with the progression of interstitial viral pneumonia followed by polysegmental pneumonia. Laboratory examinations indicated significant dynamic changes in complete blood count, biochemical parameters, and coagulation profile. Immunohistochemical analysis of biopsy material demonstrated intense macrophage infiltration with a predominance of T-lymphocytes. B-lymphocytes were either undetectable or sparsely recorded. Additionally, signs of autoimmune myocarditis were observed both during the active phase of the disease and in the post-infectious period. The pulmonary pathology observed in COVID-19 patients was accompanied by severe vasculitis, microvascular thrombosis, and hemorrhages. This clinical case underscores COVID-19 as a severe systemic pathology, highlighting the development of microthrombosis in alveolar capillaries, progression of acute respiratory distress syndrome, interstitial pneumonia, and the formation of destructive processes in the pulmonary parenchyma and pleura