Structural Changes in the Lung during Covid-19 Infection and Its Effect on Mortality Rate and Prognosis

Kasem Ms, El-Khsosy Aaf, Sherif Ws, Rashad Nz, Abdelazeem Nh, Teima Me, Sharaf Wk, Shehata Aw, Domouky Am
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Abstract

COVID-19 or SARS-Cov-19 has emerged in late 2019 as one of the highly pathogenic transmissible viruses ever known, comprising many features regarding its transmission and manifestations similar to those of its older siblings, SARS and MERS. COVID-19 has caused a pandemic that forced most of the world into isolation after threatening the lives of millions. In this article we shed more light on the structural changes that happens to the lung in the context of Reverse Transcription-Polymerase Chain Reaction (RT-PCR) confirmed COVID-19 infection based on gross examinations and CT scans, moreover, to correlate these changes to mortality rate hoping to identify the prognostic factors by which prognosis of the disease and mortality rate could be expected, higher involvement with higher severity degree in a short span of time indicates poor prognosis and high mortality chance, reviewing the literature data and records showed that the lungs undergo many changes on both macroscopic and microscopic levels (e.g. ground-glass opacity) which relates to the pathogenesis of the disease and manifestations; Most commonly pneumonia in the form of exudation of the lung with hyaline membrane formation rendering most of the lung non-functional causing hypoxemia and anosmia, all these findings that affect the lungs’ functions and lowers blood-oxygen saturation levels play a huge role in defining prognosis of the disease.
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Covid-19感染期间肺部结构变化及其对死亡率和预后的影响
COVID-19或SARS- cov -19于2019年底出现,是迄今为止已知的高致病性传染性病毒之一,其传播和表现与其哥哥SARS和MERS相似。COVID-19引发的大流行在威胁到数百万人的生命后,迫使世界大部分地区陷入隔离状态。在本文中,我们通过大体检查和CT扫描,更多地揭示了在逆转录聚合酶链反应(RT-PCR)确诊的COVID-19感染的背景下,肺部发生的结构变化,并将这些变化与死亡率联系起来,希望找到预测疾病预后和死亡率的预后因素。短时间内受累程度越高,严重程度越高,预后差,死亡率高,回顾文献资料和记录,肺部在宏观和微观层面发生许多变化(如毛玻璃样混浊),与疾病的发病机制和表现有关;最常见的肺炎表现为肺渗出物伴透明膜形成,导致大部分肺无功能,导致低氧血症和嗅觉丧失,所有这些影响肺功能和降低血氧饱和度的发现对确定疾病的预后起着重要作用。
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