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Editorial
. 2022 Sep:89:92-94.
doi: 10.1016/j.clinimag.2022.06.011. Epub 2022 Jun 25.

Characteristic patterns of SARS-CoV-2 on chest CT suggests a hematologic pathway for viral entry into the lung

Mary M Salvatore  1 , Kathleen M Capaccione  2 , Anjali Saqi  3 , Jonathan B Overdevest  4 , Rebecca Patrizio  2 , David A Gudis  4
Affiliations
Editorial

Characteristic patterns of SARS-CoV-2 on chest CT suggests a hematologic pathway for viral entry into the lung

Mary M Salvatore et al. Clin Imaging. 2022 Sep.

Abstract

Many SARS-CoV-2 studies have supported the theory that the Type II alveolar epithelial cells (AEC-2) are the primary portal of entry of the virus into the lung following its brief nasal occupation. However, the theory of inhalational transmission of the virus from the ciliated and goblet nasal cells to the lung parenchyma is not supported by the imaging findings on chest computerized tomography (CT), leading the authors to consider an alternative pathway from the nose to the lung parenchyma that could explain the peripheral, basilar predominant pattern of early disease. Imaging supports that the pulmonary capillaries may be an important vehicle for transmission of the virus and/or associated inflammatory mediators to the lung epithelium.

Keywords: COVID-19; Chest CT; Vascular endothelium.

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Figures

Fig. 1
Fig. 1
Chest CT with intravenous contrast on lung window settings in axial and coronal projection demonstrates peripheral ground glass opacities in a patient with early COVID-19 infection.
Fig. 2
Fig. 2
Non-COVID 19 bacterial pneumonia with airway-centered upper lobe predominance.\.
Fig. 3
Fig. 3
Bilateral lower lobe aspiration pneumonia with airway-centered consolidation and tree in bud opacities. Note the dilated, fluid-filled esophagus.
Fig. 4
Fig. 4
Peripheral septic emboli at the end of blood vessels are spread hematologically to the lungs.
See this image and copyright information in PMC

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