ARDS in radiation induced lung injury and covid-19 pneumonia: two different sides of the same coin. a case series comparison

Coronavirus pneumonia (Covid-19 pneumonia) is a highly severe acute syndrome due to coronavirus 2 (SARS-CoV-2) infections, which has rapidly spread to other countries beyond China resulting in a global pandemic. Severe lung disease onset might result in death due to massive alveolar damage and severe progressive respiratory failure leading to acute lung injury which predispose to severe adult respiratory distress syndrome (ARDS). Symptoms, chest CT scan features and autopsy reports by a radiation oncologist’s point of view, bring to mind a similarity with pictures of sporadic acute fatal radiation induced lung injury (RILI) which is a side effect of thoracic radiotherapy. Like two sides of the same coin, there is the feeling of a common inflammatory response of lung to an injury whatever it may be, virus, drugs or ionizing radiation as we found in these two case reports.