No cough or fever, but both lungs are white! Who is prone to this? Pay attention to 3 warning signs——

Recently, topics related to "white lung" have frequently appeared on hot searches and attracted widespread attention.

What is white lung?

White lung is a colloquial description of the imaging findings of the lungs. The lungs are composed of alveoli, which are filled with air. When a CT or X-ray examination is performed, the rays pass through the alveoli, and the images show black areas. However , when inflammation or infection occurs in the alveoli, and there are exudates and inflammatory cells, the rays cannot penetrate, and white areas appear on the imaging.

" White lung is not the only symptom of pneumonia that is caused by inflammation in the lungs. It is a more serious manifestation of pneumonia ," said Jiao Yahui, director of the Department of Medical Administration of the National Health Commission, at a press conference of the Joint Prevention and Control Mechanism of the State Council on December 27. Generally speaking, when the inflammation of the lungs is more serious and there is more exudation, that is, the white image area reaches 70% to 80% , it is colloquially called "white lung" in clinical practice. At this stage, patients will experience hypoxemia or respiratory distress.

Not only the new coronavirus, but multiple pathogens can cause lung inflammation. Jiao Yahui mentioned that respiratory syncytial virus, influenza virus, and some bacteria, such as Legionella, can cause lung inflammation, and in severe cases, inflammation symptoms can appear. "We have also noticed that some of the 'white lungs' people are talking about on the Internet are not real 'white lungs', and some are not serious enough and are mistakenly called 'white lungs'."

In terms of treatment, there is now a mature expert consensus and treatment plan. By strengthening the treatment of the primary cause of the disease, a considerable number of white lung patients can improve.

Who is prone to "white lung"?

Gong Zilong, deputy chief physician of the Department of Respiratory and Critical Care Medicine at the Fifth Hospital of Wuhan City, Hubei Province, said in an interview with The Paper on December 27, "There is no definite answer to the causal relationship between COVID-19, pneumonia, and even white lung, but from the phenomenon, the new coronavirus does have an impact on the patient's lungs. From what I have seen, most COVID-19 patients have mild symptoms, and severe cases are more common in the elderly and people with underlying diseases . For example, I see about 150 patients a day, and there are only about two or three cases of white lung."

"In October this year (2022), our hospital sent me to provide support to Wuhan Jinyintan Hospital. Because the situation was not fully relaxed at that time, the probability of large-scale contact and infection of the virus among the two more vulnerable groups, the elderly and children, was actually lower . The people who got sick were mainly young people, so the patients' symptoms were not so serious during that period ," said Dr. Gong Zilong.

Gong Zilong said that he recently observed that the new coronavirus not only invades the upper respiratory tract of the human body, but also seems to affect the lower respiratory tract, causing the "white lung" phenomenon. Relatively speaking, the impact on young people is still relatively small, and patients with underlying diseases, especially those with chronic obstructive pneumonia, structural lung disease, diabetes, obesity and other diseases , will be more affected.

Some people do not have a high fever or cough after being infected

Both lungs have turned white

Recently, Grandma Wu, a woman in her 70s from Wuhan, Hubei, was found to have been infected with the new coronavirus. However, the old woman's condition did not seem to be serious.

But four or five days later, Granny Wu suddenly became unconscious. Her family thought she had a heart attack, but after being sent to the hospital for examination, her blood oxygen level was only over 70, and the CT chest film was even less optimistic - both lungs had turned white.

Cheng Zhong, director of the First Department of Cardiology at the Wusheng Road Campus of Wuhan Fourth Hospital, said that a normal person's lungs are black on CT scans, but when Granny Wu was brought in, both of her lungs were already white and she was suffering from severe hypoxia. Several days of high-flow oxygen therapy were ineffective and she had to be put on a ventilator at one point.

Cases like Grandma Wu, who did not have a high fever or cough but eventually developed a severe lung infection and became life-threatening, often occur in hospitals.

Cheng Zhong introduced that this is a typical symptom of some elderly people infected with the new coronavirus. This phenomenon can be called "silent hypoxia". It looks calm on the outside, but it is actually very dangerous.

The main symptoms of these patients are poor appetite, drowsiness, and slow reaction . However, a blood oxygen saturation test shows that their blood oxygen saturation is only 60 to 70 percent, and the signs of lung hypoxia are very obvious.

There are several warning signs of "white lung"

"It cannot be prevented, only warned." Wu Wenjuan, from the Department of Geriatrics at Henan Provincial People's Hospital, said that based on the current situation of novel coronavirus infection, it is recommended that people over 80 years old, if they show positive symptoms, contact their community doctor or their familiar attending physician in a timely manner, and determine whether they need home observation and treatment or hospitalization based on the situation.

So for those who are under 80 years old and in good health, or have high blood pressure, diabetes, etc. but their conditions are well controlled and stable, and who want to be observed and treated at home, what changes should they be alert to?

Wu Wenjuan said that the "white lungs" caused by viral pneumonia do not form immediately. There will usually be some warning signals two or three days in advance , and everyone must pay attention to it.

For example, changes in blood oxygen saturation, heart rate, pulse , etc.

1. When an elderly person at home has a fever, the first thing to do is to observe his or her mental state, to see whether he or she is drowsy, has a poor appetite, is apathetic, or vomits , etc.

Second, there are still many elderly people with underlying diseases, and it is generally recommended to have a fingertip oximeter at home. Two changes can be noticed: blood oxygen saturation and pulse .

If the blood oxygen saturation is lower than 93 or 90 , you should pay more attention; the normal pulse is 60-100, and you should be alert if it is higher than 100. Some people have found that when the elderly are walking, the value is 95 or 96, which is good, but when they rest, it fluctuates greatly "from 95 or 96 to 93 or below" , so you should also pay attention.

3. Some people say that their elderly are usually in good health and they don't have a blood oximeter. What data should we look at? Wu Wenjuan suggested that in addition to the mental state of the elderly, we can also count the breathing rate. When the elderly are resting, count once a minute. If it exceeds 30 times, we need to be more vigilant . If the breathing rate is not clear, we can also count it by the frequency of chest movement.

Generally speaking, if the above changes occur, you should contact a medical institution in time for further examination and diagnosis.

In addition to the elderly and the very elderly who have a foundation, Wu Wenjuan reminded that people who are too obese , even young and middle-aged people, should also pay attention and be vigilant after being infected with the new coronavirus.

Source: Beijing Daily