Post-COVID ILD

[chessknt]

I have encountered a few cases of post-COVID ILD with markedly advanced lung damage. I know that most people tend to resolve this after a few months but I have a few patients that have been hospitalized for months and lungs look like advanced end stage ILD absolutely devastated but only on a smidge of O2. They all have marked eosinophilia (peripheral AEC >1000) as well.

Anyone else seeing this? How are you managing? I've seen a good response to steroids but the lung damage does not seem to regress in these individuals like I have seen in most other severe disease survivors. I have thought about lung transplant referral but the ethics of that seems murky to me since they all have pro-ivermectin anti-vax mentalities that probably shouldn't be allowed to get transplanted.

---

Members don't see this ad.

 

[Bobblehead]

I believe most transplant centers require their candidates to be vaccinated so not referring individuals who refuse vaccination is not unreasonable. Some might change their minds if you tell them that you could refer them if they do get vaccinated. I would administer the vaccine in your office though to avoid the possibility of fake vaccination cards.

 

[chessknt]

I believe most transplant centers require their candidates to be vaccinated so not referring individuals who refuse vaccination is not unreasonable. Some might change their minds if you tell them that you could refer them if they do get vaccinated. I would administer the vaccine in your office though to avoid the possibility of fake vaccination cards.

Even so how can you assess that they have stopped following pseudoscience? I still get eye rolls from their family members when I tell them that ivermectin isn’t going to help this kind of problem—the belief is still there even after seeing months of the aftermath of COVID. It is truly a refractory psychosis for some people.