An NYU Langone Radiologist Correlates COVID-19 Disease Progression with the Density of Inflammation in the Lungs
Confronted with an unfamiliar respiratory disease with unknown hallmarks, physicians have turned to their colleagues in radiology for clinical clues to help them diagnose and treat coronavirus disease (COVID-19). Early on, hazy areas of increased density, or ground-glass opacity, discernible on the X-rays or CT scans of some patients’ lungs, caught the media’s attention as being sufficient for diagnosing COVID-19. “But there are dozens of things that could cause such areas of inflammation, so it’s not the basis for a diagnosis,” notes William H. Moore, MD, chief of thoracic imaging in NYU Langone Health’s Department of Radiology.
Dr. Moore and his colleagues have found that patients with a ground-glass configuration may actually do better than those whose lungs have denser air spaces. “The central portion of the lungs shown in this 3-D rendering of a CT scan is densely consolidated,” he notes, “suggesting a poor prognosis.” More peripherally, Dr. Moore adds, there are rounded areas of ground-glass opacities. The more disease in the lower lobe, he explains, the worse the outcome may be because that’s where most oxygenation occurs. “This kind of condition is something a radiologist might see once or twice in their career,” says Dr. Moore. “Hopefully, we’ll never see anything like it again.”