COVID-19- induced Granulomatosis with Polyangiitis：a Case Report and Literature Review

Objective To report a case of Granulomatosis with Polyangiitis (GPA)with Diffuse alveolar hemorrhage(DAH)that developed following Coronavirus disease 2019 (COVID-19) in an adolescent boy, and perform a literature review to better understand this disorder.Methods Retrospectively analyze the data of a case of GPA following COVID-19 infection, to summarize the clinical characteristics of GPA following COVID-19 infection by searching the database (PubMed,Wanfang Data,CNKI) and comprehensively analyze the literature results. Results 9 cases were reported，combined with our case，there were 10 cases of GPA following COVID-19 infection,including 4 males and 6 females,with an average age of(40.6±18.6)years,and the time interval between COVID-19 and diagnosis of GPA ranged from 1 day to 3 months for all 10 cases. The rate of mortality was 10.0%(1/10).Commonly seen clinical manifestations were cough(70.0%),dyspnea(50.0%),and Arthralgia/Myalgia(40.0%). CT scans showed ground-glass opacities，multifocal pulmonary nodules.Of all these patients, c-ANCA and PR3-antibody positivity were found .Conclusion COVID-19 pneumonia and COVID-19- induced new-onset GPA share many clinical and radiological features, making it challenging for clinicians to distinguish between the two. Our study also provided some clues about the diagnostic challenge of GPA induced by COVID-19.