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Wheeze in the time of COVID-19: overcoming obstacles to an unusual diagnosis

Barclay, Mhairi; Buderi, Silviu; Bush, Andrew; Daniel, Mat; Jordan, Simon; Rice, Alexandra; Ruggins, Nigel; Semple, Thomas; Smyth, Alan Robert


Mhairi Barclay

Silviu Buderi

Andrew Bush

Mat Daniel

Simon Jordan

Alexandra Rice

Nigel Ruggins

Thomas Semple

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Professor of Child Health


This case is an example of a rare cause of a common clinical presentation (persistent lobar collapse with wheeze). We describe patient management from primary care through to a national thoracic referral centre. We highlight the importance of objective testing to support an asthma diagnosis and the need to consider alternative or additional diagnoses if a patient does not respond to treatment or the clinical course is unexpected. We highlight the importance of follow-up X-ray to determine whether atelectasis has resolved, which was significantly delayed in this case due to COVID-19 restrictions. Though rare, an endobronchial tumour should be considered if atelectasis persists and when planning endoscopy for a presumed foreign body, especially if the clinical history and patient factors make a foreign body less likely. Greater awareness of this as a differential may expedite diagnoses for patients in future. We show how virtual, multicentre, multidisciplinary meetings can aid rapid diagnosis, surgical planning and coordination of follow-up across centres.


Barclay, M., Buderi, S., Bush, A., Daniel, M., Jordan, S., Rice, A., …Smyth, A. R. (2022). Wheeze in the time of COVID-19: overcoming obstacles to an unusual diagnosis. Thorax, 77(10), 1050-1053.

Journal Article Type Article
Acceptance Date May 19, 2022
Online Publication Date Jun 29, 2022
Publication Date 2022-10
Deposit Date Jul 15, 2022
Publicly Available Date Aug 5, 2022
Journal Thorax
Print ISSN 0040-6376
Electronic ISSN 1468-3296
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 77
Issue 10
Pages 1050-1053
Keywords Pulmonary and Respiratory Medicine
Public URL
Publisher URL


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