Imaging changes of severe COVID-19 pneumonia in advanced stage

We recently reported in Intensive Care Medicine the imaging changes of acute stage from a case of 75-year-old male patient with severe COVID-19 pneumonia combined acute respiratory distress syndrome (ARDS), septic shock, and multiple organ disfunction syndrome (MODS) who had a history of 10-year hypertension and 1-year diabetes. He presently received advanced life support treatment including respiratory support (invasive mechanical ventilation) and circulatory support (vasoconstrictor assistance), as well as intermittent renal replacement therapy (IRRT) in intensive care unit (ICU) of our hospital—a tertiary teaching hospital of medical university. Because his MODS still existed on the day 20 after symptom onset, we had to re-examine the chest computed tomographic (CT). The results showed that early changes of reticular pulmonary fibrosis appeared in Panels D, E, and F (marked by green arrows), compensatory emphysema occurred in Panels D and E (marked by blue arrows), and pulmonary cavity formation appeared in Panel F (marked by blue arrows), compared with acute stage of the day 5 after symptom onset, inflammatory lesions and ground glass shadow of Panels A and B (marked by red arrows), as well as septal line of Panel C (marked by yellow arrows). Presently, this patient is still under the condition of advanced life support therapy (Fig. 1).

Fig. 1
figure1

Chest computed tomographic image changes of a 75-year-old patient infected with 2019 Coronavirus Disease (COVID-19) in advanced stage

Availability of data and materials

We stated that all the data and materials were true and available in the study.

Acknowledgements

The author thanks the patient and all members of his family.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Wei Zhang.

Ethics declarations

Conflicts of interest

All authors have read and approved the final version of the manuscript and agreed to submit it for consideration for publication in the journal. There are no ethical/legal conflicts involved in the article.

Ethics approval and consent to participate

Written consent from the patient was waived, because of entirely anonymized images from which the individual cannot be identified.

Consent to publish

The author confirms that he has read the Journal’s position on issues involved in ethical publication and affirms that this report is consistent with those guidelines.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/.

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Zhang, W. Imaging changes of severe COVID-19 pneumonia in advanced stage. Intensive Care Med 46, 841–843 (2020). https://doi.org/10.1007/s00134-020-05990-y

Download citation