What COVID-19 Looks Like in the Lungs
COVID-19 is an infectious illness caused by a new coronavirus that can infect a person’s respiratory tract by latching onto receptors in healthy cells, especially in the lungs. This can cause the lungs to become inflamed and make it difficult to breathe, possibly leading to more serious conditions like pneumonia—an infection of tiny air sacs known as alveoli inside lungs where blood exchanges oxygen and carbon dioxide.
Chest X-rays are the most commonly ordered imaging study for patients that are experiencing respiratory issues because they can help detect inflammation, pneumonia and infiltrates, which form in the lungs as the disease progresses and appear as little white spots on the X-ray.
“Infiltrates are little bits of fluid or pus that sit inside the lungs, which normally act as a sponge so people start feeling short of breath,” explains Dr. Cedric Dark, an ER physician in Houston. “They appear on an X-ray as patchy white spots all over the lungs because they have been building up with fluid and other gunk. As the diseases continues to progress, those little white spots could consolidate into Acute Respiratory Distress Syndrome (ARDS), where the lungs become completely useless and it’s almost impossible to deliver enough oxygen to keep them alive.”
CT scans are also used to provide a more detailed look at abnormalities in the lungs. Chest scans of symptomatic COVID-19 patients show certain visual hallmarks such as ground-glass opacities, which are hazy dark spots in the lungs that don’t block underlying blood vessels or lung structures; and consolidative pulmonary opacities, which are areas of increased lung density that obscure underlying vessels and structures.
Numerous celebrities and public figures have also tested positive for COVID-19, including Tom Hanks, Rita Wilson, Prince Charles, and The New York Times television editor, Jeremy Egner. When describing his X-ray, Egner said that it “looked like some demented handyman had sprayed my lungs with insulation.”
CNN anchor Chris Cuomo, who also came down with COVID-19, recently shared his chest X-ray results with Dr. Sanjay Gupta during his Cuomo Prime Time broadcast. While Cuomo was fortunate to not have developed pneumonia, there was some fluid build-up in his chest that indicated the presence of infiltrates, although Dr. Gupta pointed out that his results looked good overall.
In more critical cases, people require oxygen or breathing tubes—sometimes patients are put in a medically-induced coma while on a ventilator until they show signs of improvement. Even after recovering from COVID-19, some are left with a persistent cough or scarring in their lungs. Currently, doctors are studying whether these effects are permanent or if they will improve over time.
For those that succumb to COVID-19, X-ray images and CT scans released by the Radiological Society of North America have shown how the disease ravages the lungs of victims. The chest X-rays of a now deceased 44-year-old man in China who worked at the Wuhan seafood market (which was thought to be the origin of the outbreak) show white patches in the lower corners of the lungs, indicating “ground glass opacity”–a term coined by radiologists to describe the partial filling of air spaces. Over time the man’s lungs became more pronounced, and he was eventually diagnosed with pneumonia and ARDS prior to passing away.
CT scans of a 45-year-old woman from China who also tested positive for COVID-19 showed white patches and a reversed halo sign in the upper left lobe of her lung. In her case and others, the abnormalities detected by doctors are also similar to those found in patients suffering from severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS).
Currently, the swab-testing method for detecting COVID-19 is expensive, limited in availability, and takes a long time for results to come back. Chest X-rays have proven to be critical to patient triage efforts by helping to detect severe lung damage and prioritize care for patients. Within Health’s app connects individuals to radiologists and partner imaging centers, helping to determine if chest X-rays are necessary and if further medical attention is required. For more information, click here.
