新型冠状病毒肺炎（简称“新冠肺炎”）主要临床表现为发热、咳嗽、气促及呼吸困难等，多数患者经积极抗病毒等对症处理后可缓解，少数重症患者效果差，需警惕合并急性纤维素性机化性肺炎（AFOP）的可能。AFOP是特发性间质性肺炎的一种罕见病理学类型，可以是特发性或继发性，激素抗炎或免疫抑制剂治疗有效，早期识别新冠肺炎合并AFOP对临床疗效有显著改善。本文34岁女性患者，确诊新冠肺炎入院，予以抗病毒及强力抗菌等对症处理后患者疗效差，病情进一步进展，结合临床及影像学考虑合并AFOP的可能，予以激素抗炎治疗，患者在临床表现及影像学上明显改善。提示新冠肺炎患者需警惕合并AFOP的可能。

COVID-19 is the pneumonia caused by infection with a new type of coronavirus. The main clinical manifestations are fever, cough, shortness of breath, and dyspnea. Most of the symptoms can be relieved after treatment such as active antiviral measures. A few severe patients may have poor results and acute fibrinious and organizing pneumonia (AFOP) as a potential complication which should be noticed in these patients. AFOP is a rare pathological type of idiopathic interstitial pneumonia which can be idiopathic or secondary. Hormonal anti-inflammatory or immunosuppressive treatment is effective strategies. Early identification of new coronary pneumonia combined with AFOP is crucial for better outcome. Here we report a 34-year-old woman who was admitted to the hospital with a definite diagnosis of new coronary pneumonia. The patient development to a severe condition with a unresponsiveness to the treatment. Combine with the clinical and imaging results, the possibility of AFOP was considered and treated with glucocorticoids therapy. Clinical manifestations and imaging improved significantly after the treatment which indicate that the patient may complicate with the AFOP.