WHAT IS YOUR DIAGNOSIS?
A 67-year-old man with a history of COVID-19 infection was admitted to our hospital due to cough and hemoptysis. The patient was hospitalized with a COVID-19 diagnosis (positive PCR assay) 50 days ago in another hospital and had been treated with remdesivir and high dose steroid (methylprednisolone 500mg for three days followed by dexamethasone) after which he developed hyperglycemia and the creatinine level was increased. After improving from COVID-19, the patient has developed a productive cough, which has been exacerbated recently. During the last two weeks, the patient has become febrile. He had an episode of massive hemoptysis five days before. The patient had a history of hypertension and ischemic heart disease but he was not diabetic. On physical examination, the patient was ill with stable vital signs. On pulmonary examination crackles were heard on the right lung. Other physical exams were unremarkable. Laboratory tests are summarized in Table1. Abdominopelvic sonography was normal. In echocardiography, the patient had an ejection fraction (EF)=40%. Figure1 shows chest computed tomography (CT) on the first day of the second admission.