"White Lung" has become a hot topic among netizens recently.
"I keep coughing after recovery. Do I have white lungs?"
"It is said on the Internet that white lungs may appear after recovery. It's scary. Do you want to get a CT scan?"
Many netizens who have recovered from the new crown have raised such concerns, so what exactly is white lungs? How does white lung form?
What is white lung?
White lung is not an exact disease, but a colloquial description of medical images (CT, X-rays, etc.).
CT or X-ray films taken from healthy lungs are black because the air in the alveoli is transparent;
And in diseased lungs, when inflammation and infection occur in the alveoli and there are exudates or inflammatory cells, they are opaque, so the CT or X-ray films are large white areas.
via: "Imaging Diagnosis and Artificial Intelligence of New Coronavirus Pneumonia"
If white lungs appear, it may mean there is a problem with the lungs . Severe pneumonia and lung cancer may cause a layer of "white mist" to cover the chest X-ray.
At present, many people appear white lungs, which may be a relatively serious manifestation of pneumonia. At this stage, patients will experience hypoxemia or respiratory distress. (Content source: Jiao Yahui, Director of the Department of Medical Affairs of the National Health Commission)
Below we will only discuss what everyone is more concerned about: The white lung problem caused by new coronavirus infection . (After all, lung cancer, neonatal wet lung syndrome, etc. may also cause white lungs)
What is the probability that new coronavirus infection will cause white lungs
?
This question is actually: What is the probability of new coronavirus infection causing severe pneumonia.
The pathogenicity of the currently popular Omicron strain has been significantly reduced, with few symptoms of pneumonia, and the probability of causing severe pneumonia is even smaller [1].
Physicians in pulmonary medicine also said: The probability of white lung infection caused by new coronavirus infection is not very high.
(Content source: Deputy Chief Physician of the Respiratory Care Unit, Shanghai Pulmonary Hospital Affiliated to Tongji University Zhang Li, Deputy Chief Physician of the Department of Respiratory and Critical Care Medicine, Wuhan Fifth Hospital, Hubei Province Gong Zilong)
How to determine whether your lungs are infected?
Does CT need to be taken? The symptoms of pneumonia are mostly fever, cough, chest pain, etc. They are very similar to the respiratory symptoms of COVID-19 infection and are difficult to distinguish.
But severe pneumonia can be assisted by blood oxygen nail meter : if the indicators are 95%, if they are 93%, or even 90%, it may be a sign of severe illness. (Content source: Epidemiologist Zeng Guang)
via: Photo Network
It is currently not recommended to take CT for patients with mild COVID-19 infection. Patients with the following symptoms can take CT to check whether they have pneumonia
① COVID-19 patients with the following severe symptoms:
- Stubborn cough, sputum production, hemoptysis, purulent sputum
- Recurrent fever, persistent high fever
- Difficulty breathing, gasping and holding your breath
- Abdominal distension, nausea, vomiting, loss of appetite, headache, fatigue, irritability, lethargy and other extrapulmonary symptoms
- Hypoxia, cyanosis (bluish color of lips, finger tips, etc.), shock and other critical illnesses Situation
② For the elderly who have underlying diseases, such as diabetes, COPD, coronary heart disease, cardiac insufficiency, heart failure, kidney failure, etc., it is recommended to go to the hospital for a CT scan after being infected with the new coronavirus.
How to "treat" white lung?
If it is a white lung image caused by severe pneumonia, the current treatment methods are:
●Prone position treatment, no less than 12 to 16 hours a day[2].
●Carry out oxygen therapy, including non-invasive ventilator , invasive ventilator , and ECMO, which is called a life-saving tool by netizens. (Content source: Jiao Yahui, Director of the Department of Medical Affairs of the National Health Commission)
Antiviral treatment: Take antiviral drugs [2], such as , Azivudine, and Paxlovid. Note that these drugs have contraindications. For example, patients with poor liver and kidney function are not recommended to use them, so should be taken under the advice of a doctor.
Can lung function be restored after white lung appears?
can be restored, but it is difficult to return to its original healthy state.
Experts have calculated that one year after recovery from the new coronavirus delta strain, although the patient's lung function will recover, the recovery trend will not last long and will show an irreversible downward trend.
Dr. Galiatsatos of Johns Hopkins University Hospital also said, "It takes time for COVID-19 patients to recover from lung damage. Initially there is lung injury, followed by scarring. Over time, the tissue will heal, but it may take three months to a year or more for a person's lung function to return to the level before COVID-19 infection."
Can white lung be prevented?
White lung cannot be prevented, it can only be said to be an early warning.
① It is recommended to regularly monitor blood oxygen after infection
Although some patients do not have symptoms such as chest tightness and shortness of breath, their lungs may be severely hypoxic. This is called "silent hypoxia."
It is recommended to prepare a oximeter at home, especially if there are elderly people or patients with underlying diseases at home. Once the blood oxygen saturation is found to be lower than 93%, you need to pay attention and seek medical treatment in time.
② Pay attention to the respiratory rate heart rate
In the absence of an oximeter, you can self-test. If you feel difficulty breathing, shortness of breath, the respiratory rate is 30 times/minute, or other factors such as fever are excluded, the heart rate is 120 times/minute, you should be alert to the possibility of hypoxia.
③ After four doses of vaccine
An experimental team from Singapore analyzed samples from the elderly and found that vaccination can reduce the incidence of pneumonia after infection, especially four doses of the mRNA vaccine, which has a better protective effect than other vaccines [3].
Finally, I hope you don’t worry too much about white lung. If you have underlying diseases, do a good job of monitoring. I wish you all a smooth recovery from the new crown~
Special reminder: The content of this issue has been reviewed by professional doctors. The above popular science content is only for the exchange of experiences. Taking into account individual differences, if you feel unwell, you can consult a professional doctor online; if you have an emergency or severe illness, please go to an offline hospital immediately!
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Yuanxin Health New Media Group (Unauthorized reproduction is prohibited)
References
[1] Symptom prevalence, duration, and risk of hospital admission in individuals infected with SARS-CoV-2 during periods of omicron and delta variant dominance: a prospective observational study from the ZOE COVID Study https://pubmed.ncbi.nlm.nih.gov/35397851/
[2] National Health Commission of the People's Republic of China. Diagnosis and Treatment Plan for Novel Coronavirus Pneumonia (Trial Ninth Edition) [J]. Chinese Journal of Clinical Infectious Diseases, 2022, 15(02): 81-89.
[3] "Comparative effectiveness of 3 or 4 doses of mRNA and inactivated whole-virus vaccines against COVID-19 infection,hospitalization and severe outcomes among elderly in Singapore》
