Prolonged Disease Course of COVID-19 in a Patient with CTLA-4 Haploinsufficiency

Figure 1

chest computed tomography scan at age 22 years, as well as multiple scans during follow up over the years. The scan at age 33 years was made when the patient presented to the emergency department with COVID-19. (a) Bilateral consolidations that are not well circumscribed, multiple nodules, fissural and pleural irregularities and multiple ground glass areas. Diffuse thickening of bronchial walls. Overall appearance suggestive of granulomatous disease. (b) Disappearance of multiple consolidations, and appearance of multiple new consolidations and ground glass abnormalities. (c) Disappearance of some consolidations in the lower fields, but appearance of new consolidations in the upper fields. (d) Disappearance of some consolidations and appearance of new consolidations and ground glass. (e) New consolidation in the left lower lobe. (f) Impressive progression of bronchiectasis in the left lower lobe, disappearance and appearance of consolidation and ground glass. (g) New consolidations and ground glass, mainly in the lower fields. (h) Pneumothorax on the left side, increase in ground glass and consolidations in both lungs. (i) Increase in pneumothorax on the left side, mediastinal shift to the right, increased bronchiectasis in the middle lobe. (j) Increased air in left upper lobe.

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