Inside Covid’s life and breath battle

Lung images reveal disease’s deadly toll

IF a picture speaks a thousand words, then this one says “get vaccinated”.

Telling CT scan images of the lungs of a patient battling Covid-19 can be revealed, alongside those of a healthy patient’s ones, showing just how viciously the disease attacks key organs.

The lungs with extensive white blemishes are succumbing to the virus, while the ones without are fighting fit and normal.

Health experts say the images should serve as an urgent wake up call to anyone yet to be vaccinated.

The head of radiology at Royal Melbourne Hospital Associate Professor Stefan Heinz said the CT scan of the healthy lungs are black and showing “basically all air”.

“Air is black on a CT scan,” Professor Heinz said.

“The lungs in the patient who has Covid are all white and full of inflammatory cells and virus and abnormal cells.

“When it gets as bad as the one in the CT scan they can end up needing to have mechanical ventilation so you really have to pump the air in through an endotracheal tube.”

If the patient deteriorated further they might need an even more drastic treatment called Extracorporeal Membrane Oxygenation where the patient’s blood vessels are hooked up to a machine that oxygenates them externally.

President of the Australasian Society for Infectious Diseases Professor Allen Cheng said this was “basically a lung bypass machine where a machine is doing the work of the lungs”.

The scans show the patient with Covid is relying on less than half their lung capacity, which is incompatible with survival, Professor Heinz said.

“That’s why he’s got these tubes, that’s the ETT or the endotracheal tube, that’s where you have an operation that just goes down into your trachea and then mechanically ventilates you and that allows them to get a lot more oxygen to the parts of the lungs that are working,” he said.

“This guy, we know is really sick because he’s got this tubing, he’s also got a nasogastric tube that allows them to give medications directly into the stomach, because he won’t be able to swallow.”

The Covid patient would be sedated, unconscious and mechanically ventilated, with ECG leads to monitor him.

“As soon as you pull that one up you know this guy’s in big trouble because we’ve got all these tubes, you know that he’s in dire straits,” he said.

Professor Cheng said the lungs of Covid patients could become scarred which affected them for weeks – and there were other complications from the illness.

“Sometimes the kidneys fail and you need to do dialysis. The other complication that is relatively common is clotting problems, so you can get clots in the lungs and if your lungs are weakened already … that can be more of an issue,” he said.

The message from the images was “vaccination, vaccination,” Professor Heinz said.

“It’s safe, it’s easy, it’s quick and it’s the best way to protect yourself and protect your family and community,” he said.