• Satoshi Okamori, Ho Lee, Yasushi Kondo, Yuto Akiyama, Hiroki Kabata, Yuko Kaneko, Makoto Ishii, Naoki Hasegawa, and Koichi Fukunaga.
• Division of Pulmonary Medicine.
• Medicine (Baltimore). 2020 Aug 28; 99 (35): e21804e21804.

IntroductionPneumonia is one of the most important characteristics of coronavirus disease 2019 (COVID-19) and imaging findings of COVID-19 pneumonia are diverse and change over disease course. However, the detailed clinical course of organizing pneumonia (OP) caused by COVID-19 has not been clarified.Patient ConcernsA 60-year-old man and a 61-year-old woman diagnosed with mild COVID-19 were admitted to our hospital. Their respiratory symptoms were deteriorating even after initiating treatment with antiviral drugs.DiagnosisChest X-rays and computed tomography scan showed a rapid progression of linear consolidation with reversed halo sign, distributed in subpleural and peri-bronchial regions. They also presented with pulmonary fibrosis findings, including traction bronchiectasis and marked lung volume reduction. They were diagnosed with rapidly progressing OP.InterventionsThey were treated with systemic corticosteroids.OutcomesThe patients' imaging findings and respiratory conditions improved rapidly without any adverse effects.ConclusionPhysicians should carefully monitor patients with COVID-19, as they can develop rapidly progressive and fibrotic OP, which respond to corticosteroids.

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