CT Scans Show What Coronavirus Did to the Lungs of COVID-19 Sufferers

Medical imagery of people suffering from COVID-19—the disease caused by the SARS-CoV-2 coronavirus—shows how the condition affects the lungs of patients.

CT scans have become the "first line of defense" in diagnosing suspected infections, especially given the current shortage of testing kits, according to Radiological Society of North America (RSNA)—which has published a series of images in several scientific papers.

Among the studies is one paper published in the RSNA journal Radiology: Cardiothoracic Imaging which describes the case of a 44-year-old man who was a transportation staff member in the Huanan seafood market in Wuhan, China—which is thought to be where the outbreak originated.

The man had been suffering from high fever and coughing for 13 days when he was admitted to hospital on December 25, 2019. There he was diagnosed with severe pneumonia—a condition characterized by inflammation of the air spaces in the lungs—and acute respiratory distress syndrome, according to the study.

Eventually, doctors diagnosed him with COVID-2019 after ruling out infection with other pathogens which can lead to pneumonia. Despite efforts to save him, the man unfortunately died around one week later.

"This case occurring at the epicenter outbreak of COVID-19 pneumonia illustrates the potential severity of this disease, at the same time that it underscores the role of imaging for monitoring disease progression," the authors of the paper wrote. "Moreover, CT could also have an important diagnostic role, especially when confirmatory tests are unavailable."

In the CT scans of his lungs, white patches can clearly be seen. Usually, this is a sign of an abnormality that radiologists call "ground glass opacity"—or a partial filling in of air spaces in the lungs.

COVID-19 lungs
Images in a 44-year-old man who presented with fever and suspected COVID-19 pneumonia. Qian L, Yu J, Shi H. Severe acute respiratory disease in a Huanan seafood market worker: Images of an early casualty. Radiology: Cardiothoracic Imaging doi: 10.1148/ryct.20202000033. Published online February 1, 2020. © Radiological Society of North America.

Sean Jorgensen Callahan, an assistant professor of Internal Medicine at the University of Utah—who was not involved in either of the case study papers, said COVID-19 can cause inflammation in the small air spaces of the lungs causing fluid to build up. This means that oxygen can't transfer properly from the lungs into the bloodstream.

"When this happens, patients can be very short of breath, have low oxygen levels, cough, and have other respiratory symptoms," he told Newsweek. "Normal lungs on these CT scans are black or dark grey. The abnormal areas are white."

Callahan noted that the importance of CT scans in diagnosing COVID-19 depends on the patient: "If you have a patient you think was exposed to COVID and has typical symptoms then a chest X-ray that looks like a COVID infection is likely sufficient and the patient doesn't need a CT scan," he said. "It's important to note that we are seeing lots of impressive CT scans, but the findings are non-specific, meaning we see these findings in other diseases."

The ground glass opacity can also be seen in CT scans of the lungs of a 54-year old woman from Wuhan, who also became infected with the novel coronavirus, known and SARS-CoV-2. Unlike the previous case, however, this woman survived. Scans taken following several days of supportive and antiviral treatment showed significant improvement in the extent and density of the ground-glass opacities.

COVID-19 lungs
Lungs of a 54-year-old woman who presented with fever on day 2 of symptoms. Wu Y, Xie Y-I, Wang X. Longitudinal CT findings in COVID-19 pneumonia: Case presenting organizing pneumonia pattern. Radiology: Cardiothoracic Imaging doi: 10.1148/ryct.20202000031. Published online February 1, 2020. © Radiological Society of North America.
COVID-19 lungs
A follow-up CT on day 11, three days after initiation of antiviral treatment, showed significant improvement of the ground-glass opacities. Wu Y, Xie Y-I, Wang X. Longitudinal CT findings in COVID-19 pneumonia: Case presenting organizing pneumonia pattern. Radiology: Cardiothoracic Imaging doi: 10.1148/ryct.20202000031. Published online February 1, 2020. © Radiological Society of North America.

These kinds of abnormalities are also seen in patients suffering from SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome)—which are both in the coronavirus family of SARS-CoV-2.

On Wednesday, the World Health Organization (WHO) confirmed that the latest outbreak of COVID-19 is a pandemic with Director-General Tedros Adhanom Ghebreyesus calling on nations around the world to take "urgent and aggressive action."

The number of recorded cases of COVID-19 worldwide is over 130,000, with more than 4,700 confirmed deaths and over 68,000 recovered cases. Commonly reported symptoms for patients with COVID-19 include mild to severe respiratory illness, fever, coughing and difficulty breathing.

According to the WHO, more than 80 percent of COVID-19 cases are mild, however, the disease is thought to have a mortality rate of nearly three-and-half percent.

World Health Organization advice for avoiding spread of coronavirus disease (COVID-19)

Hygiene advice

  • Clean hands frequently with soap and water, or alcohol-based hand rub.
  • Wash hands after coughing or sneezing; when caring for the sick; before; during and after food preparation; before eating; after using the toilet; when hands are visibly dirty; and after handling animals or waste.
  • Maintain at least 1 meter (3 feet) distance from anyone who is coughing or sneezing.
  • Avoid touching your hands, nose and mouth. Do not spit in public.
  • Cover your mouth and nose with a tissue or bent elbow when coughing or sneezing. Discard the tissue immediately and clean your hands.

Medical advice

  • If you feel unwell (fever, cough, difficulty breathing) seek medical care early and call local health authorities in advance.
  • Stay up to date on COVID-19 developments issued by health authorities and follow their guidance.

Mask usage

  • Healthy individuals only need to wear a mask if taking care of a sick person.
  • Wear a mask if you are coughing or sneezing.
  • Masks are effective when used in combination with frequent hand cleaning.
  • Do not touch the mask while wearing it. Clean hands if you touch the mask.
  • Learn how to properly put on, remove and dispose of masks. Clean hands after disposing of mask.
  • Do not reuse single-use masks.