Inflammation in the lungs is not always called "white lung," and experts explain why the number of new cases of pneumonia is increasing

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Recently, there are voices on the Internet saying that new coronavirus infected patients were found to have pneumonia or white lung on CT during the consultation process, is this due to the underestimation of virulence of the virus or something else?

In this regard, at a press conference held by the State Council on December 27th, Jiao Yahui, Director General of the Medical Department of the National Health and Wellness Commission, responded that the so-called “white lung” is not related to the original strain or vaccination, and that the current prevalent strain is still the Omicron strain.

Jiao Yahui said that the so-called white lung is a colloquial description of the lung’s imaging performance. The lungs are made up of alveoli, which are filled with air. When CT or X-ray examinations are performed, the rays pass through the alveoli and the image appears as a black area, but when there is inflammation or infection in the alveoli, with exudate and inflammatory cells, the alveoli are filled with these exudate and inflammatory cells, and the rays do not penetrate and appear as a white area on the image. This white area reflects the imaging appearance of the exudate and does not mean that the solid lung tissue becomes white. As the exudate is absorbed and the inflammation subsides, the manifestation of white lung will gradually subside and the imaging of the lung will gradually revert to a black area. It is not always called white lung whenever there is inflammation in the lungs; white lung should be a more severe manifestation of pneumonia.

“Generally speaking, when the inflammation of the lung is more severe and exudates more, that is, when the white imaging area reaches 70% to 80%, in clinical terms people colloquially call it white lung, so not whenever there is inflammation is white lung. At this stage the patient will develop hypoxemia or respiratory distress. This type of patient may appear clinically, especially in patients of advanced age with severe underlying disease, but the percentage of such patients is very low. We have also noticed that some of the white lung that people are talking about on the internet nowadays is not really white lung, and some of it has not reached a very severe level, misrepresenting it as white lung. Not only the new coronavirus, but multiple pathogens can trigger inflammation in the lungs, like respiratory syncytial virus, influenza virus, including some bacteria such as Legionella can trigger inflammation in the lungs, and all can show inflammatory manifestations in severe cases.” Jiao Yahui said.

However, a specialist in respiratory and critical care medicine told Firstrade that it is still important to be alert to the increase in new coronary pneumonia cases.

But in the expert’s opinion, this increase in cases of neo-crown pneumonia is not related to the underestimation of virulence of the virus, but mainly to the large base of people infected with neo-crown and the combination of some other lung infections.

“It is relatively clear that the virulence of Omicron is decreasing compared to the original strain of New Crown. However, when the base of neo-crown infections is very large, the number of cases that develop into pneumonia increases, and in turn the number of cases that develop into severe and critical illnesses increases accordingly, and this number cannot be underestimated. For example, if 10,000 people are infected with Neocon, 1% of them will develop pneumonia, which translates into 100 people developing pneumonia. Assuming 100,000 people are infected, 1,000 people will develop NCC pneumonia. When millions of people are infected with Neoplasia, the number of cases of Neoplasia pneumonia will increase exponentially, and this situation still needs to be taken seriously. In addition, in some patients of advanced age or with underlying diseases, after infection with neo-crown, sometimes there may be a combination of lung infections, and in addition to the infection caused by the virus itself, there may be secondary bacterial infections, or infections caused by microbial infections, etc.”

The expert also said that from the Omicron virus characteristics, although the vast majority of infected people show mainly upper respiratory symptoms, but from clinical observation, the virus is still relatively easy to invade the human lower respiratory tract, which should not be taken lightly. “When faced with a large base of neo-crown infections, it is essential to intervene in the early stages of disease development to curb the occurrence of severe illness and death.”

At present, the center of China’s new crown epidemic prevention and control work has shifted from infection prevention to medical treatment, the goal of the work is to “protect health, prevent serious illness”.

In the State Council joint prevention and control mechanism held a press conference, Jiao Yahui also called for strengthening the monitoring of the health status of the elderly, to move the gate forward. The elderly occurrence of infection, especially the emergence of respiratory distress and other turn heavy, must be timely consultation. The current also requires that for elderly patients with serious illnesses do not need to go through the graded treatment level by level referral, to be referred directly to tertiary hospitals for consultation and treatment. In addition, she also urged the elderly to enhance vaccination so as to prevent and reduce the occurrence of serious illness and death.