• Tomoyuki Kimura, Chisato Onitsuka, Tomoko Kawahara, Yosuke Fukuda, Tetsuya Homma, Taro Watanabe, Koichi Ohsugi, Yuki Ichikawa, Atsuko Shono, Toru Kotani, and Hironori Sagara.
• Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo 142-0064, Japan.
• Medicina (Kaunas). 2021 Sep 25; 57 (10).

Abstract(Background) COVID-19 is caused by SARS-CoV-2 infection and may result in unfavorable outcomes. A recent large-scale study showed that treatment with dexamethasone leads to favorable outcomes in patients with severe COVID-19, and the use of extracorporeal membrane oxygenation (ECMO) has also been shown to improve outcomes. Recently, secondary organizing pneumonia (SOP) has been reported after SARS-CoV-2 infection, but the diagnostic and treatment strategies are still unclear. (Case presentation) Here, we report a patient with severe COVID-19 who developed SOP even after the use of dexamethasone, for whom the introduction of ECMO on the 19th day after hospitalization led to a favorable outcome. (Conclusions) Life-threatening SOP may evolve even after the use of dexamethasone, and the late-phase introduction of ECMO may save such patients with COVID-19.

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