Viral Pneumonia

This is just a refresher of how lungs look like in cases of a severe viral pneumonia. Findings on both X-ray and CT are nonspecific for COVID-19 but those are the findings we can see. The important factor is progression of the lung changes and diffuse distribution in both lungs. There is some predilection for the peripheral and lower parts of the lungs. Opacities are more diffused of type "ground glass" compared to more dense in bacterial pneumonia. Increased interstitial pattern can be seen. The end result in severe cases is diffuse lung edema or ARDS that leads to death.

85 years old patient with heart failure. Note diffuse, mostly interstitial opacities in both lungs especially in the right upper lobe and apical segment of the left lower lobe.

57 years old patient, shortly on respirator that died with cause of death officially announced as heart failure. Note diffuse predominantly interstitial "ground-glass" opacities most prominent in the left upper lobe.

Same 57 years old patient later on showing advanced diffuse pneumonia in both lungs. In such cases lungs are filled with fluid. The oxygenation capacity is markedly reduced.

I do not have official confirmation of COVID-19 in those two patients. I reported those cases in the early stages of COVID-19 pandemy when not all patients were screened for virus. In both cases onset of symptoms and death in second case were rapid. I do not have follow-up on the first patient.

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