As one-third of humanity is currently under lockdown, medical professionals around the world are facing a battle against COVID-19, working quickly to push through new tests, vaccinations, and treatment options. In an attempt to understand the “unseen enemy,” a Washington DC doctor has released a three-dimensional video of the damage coronavirus can have on a patient’s lungs.
Video created from digital CT scans of an otherwise healthy 59-year-old male with hypertension, who was not considered immunosuppressed, shows extensive damage to the lung tissue highlighted in yellow. It is a “striking feature” that highlights that COVID-19 damage to the lung is bilateral, meaning that it affects both lungs, and is diffuse.
“[The damage] is not limited to any one part of the lung. As each day goes by, healthcare workers on the frontline continue to astounded by the severity of the damage to the lungs and the speed with which it can happen,” Dr Keith Mortman, director of thoracic surgery at the George Washington University School of Medicine and Health Sciences (GWUH) who produced the video, told IFLScience.
The man presented to an outside hospital with a fever, cough, and difficulty breathing. His shortness of breath progressed rapidly and he soon required intubation and mechanical ventilation. At this point, he was sent to GWUH for extracorporeal membrane oxygenation, a treatment that uses a pump to circulate blood through artificial lungs and back into the patient’s bloodstream.
“Patients suffer a one-two punch,” said Dr Mortman. “The initial insult is a viral infection. But then the lungs create an inflammatory process around the infection. It is a combination of infection and inflammation that leads to the symptoms of cough and breathlessness as well as the need for supplemental oxygen that can progress to mechanical ventilation and in some cases death.”
CT scans of another COVID-19 patient’s lungs showed that the novel coronavirus appears to attack the lungs in a specific way, resulting in “ground-glass opacities” that depict air spaces in the lungs filling with liquid, as well as a collapse of the lung’s alveoli, which exchange oxygen and carbon dioxide molecules to and from the bloodstream. For many patients, particularly those with only mild symptoms, Mortman suspects the lung damage is temporary. For those with more severe symptoms, there is a chance that, if they survive, they may have long-term damage to the lungs. However, he adds that it is too early to know the answer with certainty.
Mortman adds that such a severe case in a person who is not considered elderly shows just how much remains unknown about the virus. Previous studies have suggested that children have milder symptoms of the disease, though all age groups are now seeing severe cases.
“The US experience right now is not consistent with the early reports out of China and other countries that stated this was mostly a disease of the elderly and that younger people are immune. This is simply not the case,” said Mortman. “Although younger people do tend to have less severe cases of the virus, they are not immune. There is a 12-year-old in Georgia on the ventilator and California reported its first teenage death earlier this week.”
It is important for all ages, particularly younger generations, to understand how the virus is transmitted. For example, it is possible for a young person to be infected and not show symptoms, making them an asymptomatic carrier capable of spreading the virus to family, friends, and strangers if physical distancing and proper hygiene measures aren’t taken. For this reason, it is crucial to “flatten the curve” to contain virus spread, and not allow hospitals and healthcare institutes to be overwhelmed.
“We stay at work for you. Please stay home for us,” concludes Mortman.