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Here’s what coronavirus does in the body

Excerpt

Zoonotic coronaviruses, ones that hopped from animals to humans like SARS and MERS, can spark a viral-induced fire throughout many of a person’s organs, and the new disease, COVID-19, is no exception when it is severe.

But what actually happens to your body when it is infected by the coronavirus? The new strain is so genetically similar to SARS that it has inherited the title SARS-CoV-2. So combining early research on the new outbreak with past lessons from SARS and MERS can provide an answer. From blood storms to honeycomb lungs, here’s an organ-by-organ look at how COVID-19 harms humans.

FULL STORY: National Geographic

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Coronavirus pneumonia: CT scan findings – II

Images

Thirty five-year-old man with 2019-novel coronavirus pneumonia.

A–D. Axial computed tomography (CT) images of upper, middle, and lower lobes of right lung and lower lobe of left lung show multifocal regions of patchy consolidation and nodular ground-glass opacities, mainly distributed along bronchial bundles and subpleural regions. E. Coronal reformation CT image shows multifocal nodular ground glass opacities in right lower lung lobe.

ORIGINAL REPORT: Korean Journal of Radiology

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Potential for lung recruitment estimated by the R:I ratio

Abstract

Rationale: Response to positive end-expiratory pressure (PEEP) in acute respiratory distress syndrome depends on recruitability. We propose a bedside approach to estimate recruitability accounting for the presence of complete airway closure.

Objectives: To validate a single-breath method for measuring recruited volume and test whether it differentiates patients with different responses to PEEP.

Methods: Patients with acute respiratory distress syndrome were ventilated at 15 and 5 cm H2O of PEEP. Multiple pressure–volume curves were compared with a single-breath technique. Abruptly releasing PEEP (from 15 to 5 cm H2O) increases expired volume: the difference between this volume and the volume predicted by compliance at low PEEP (or above airway opening pressure) estimated the recruited volume by PEEP. This recruited volume divided by the effective pressure change gave the compliance of the recruited lung; the ratio of this compliance to the compliance at low PEEP gave the recruitment-to-inflation ratio. Response to PEEP was compared between high and low recruiters based on this ratio.

Measurements and Main Results: Forty-five patients were enrolled. Four patients had airway closure higher than high PEEP, and thus recruitment could not be assessed. In others, recruited volume measured by the experimental and the reference methods were strongly correlated (R2 = 0.798; P < 0.0001) with small bias (−21 ml). The recruitment-to-inflation ratio (median, 0.5; range, 0–2.0) correlated with both oxygenation at low PEEP and the oxygenation response; at PEEP 15, high recruiters had better oxygenation (P = 0.004), whereas low recruiters experienced lower systolic arterial pressure (P = 0.008).

Conclusions: A single-breath method quantifies recruited volume. The recruitment-to-inflation ratio might help to characterize lung recruitability at the bedside.

SOURCE: Am J Respir Crit Care Med

R:I in COVID-19: graph