Rapid pulmonary calcification within 10 days in a COVID-19 patient: a case report

Pulmonary calcification typically occurs months to years after chronic infections or metabolic disorders. In contrast, it is exceedingly rare in acute viral pneumonias. We report the first case of rapid intrapulmonary calcification within 10 days of SARS-CoV-2 infection. An 82-year-old male was admitted with fever and cough. Chest CT revealed scattered calcified foci with a density of 250 HU. Following antiviral therapy (simnotrelvir/ritonavir) and corticosteroids, the calcified lesions exhibited dynamic changes correlating with the inflammatory status. Specifically, partial resolution in early stages, followed by an increase during clinical deterioration, and persistence at discharge. Laboratory tests excluded metabolic causes of calcification (serum calcium, alkaline phosphatase, and parathyroid hormone were within normal limits). COVID-19 may be associated with rapid pulmonary calcification, with serial CT imaging providing a means to track dynamic lesion changes. The underlying mechanisms and long-term clinical significance remain uncertain and warrant further investigation.