Chinese doctors released chest scans of a 33-year-old coronavirus patient that show what the illness looks like in her lungs

A suspected coronavirus patient fills out a form at a community health station before being transferred to a hospital in Wuhan on January 27, 2020.

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A suspected coronavirus patient fills out a form at a community health station before being transferred to a hospital in Wuhan on January 27, 2020.
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Feature China/Barcroft Media/Getty Images

When a 33-year-old woman arrived at a hospital in Lanzhou, China, she’d had a fever and cough for five days. The patient, who is being kept anonymous, had a temperature of 102 degrees Fahrenheit. Her breathing was “coarse,” doctors wrote, and she had a low white blood cell count – a sign of infection.

Doctors diagnosed her with the new coronavirus that has spread throughout China. As of Wednesday, more than 24,000 cases have been recorded and 494 people have died.

In a study released in the journal Radiology last week, a group of researchers at The First Hospital of Lanzhou University presented two of the woman’s CT scans side by side.

The scans show white patches in the lower corner of her lungs, which indicate what radiologists call “ground glass opacity.”

“If you zoom in on the image, it kind of looks like faint glass that has been ground up,” Paras Lakhani, a radiologist at Thomas Jefferson University who was not involved in the study but examined the images, told Business Insider. “What it represents is fluid in the lung spaces.”

Coronavirus patient chest x ray

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Junqiang Lei, Junfeng Li, Xun Li, and Xiaolong Qi

But the coronavirus might still be present even if a person’s CT scan is normal.

In a follow-up study released on Tuesday, the Lanzhou researchers found that the new coronavirus doesn’t always show up in scans right away. In an examination of 21 patients who displayed symptoms of the virus, the researchers identified three patients with normal CT scans.

“We can’t rely on CT alone to fully exclude presence of the virus,” Michael Chung, the study’s lead author, said in a statement.

The scans of the 33-year-old patient, however, provide researchers a few new clues about the nature of the virus.

The scans show the new coronavirus looks similar to SARS and MERS

Coronaviruses are a large group of viruses that typically affect the respiratory tract. They also cause pneumonia and the common cold. Symptoms of the new coronavirus include a fever, chills, headaches, difficulty breathing, and a sore throat.

Until December, it had never been seen in humans.

The novel coronavirus was first identified among a small group of people exhibiting pneumonia-like symptoms in Wuhan, China. The 33-year-old patient whose lungs are shown in the new scans works in Wuhan, but had traveled to Lanzhou a day before her symptoms started.

A member of the Thai Airways crew disinfects the cabin of an aircraft during a procedure to prevent the spread of the coronavirus at Bangkok's Suvarnabhumi International Airport, Thailand, January 28, 2020.

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A member of the Thai Airways crew disinfects the cabin of an aircraft during a procedure to prevent the spread of the coronavirus at Bangkok’s Suvarnabhumi International Airport, Thailand, January 28, 2020.
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Athit Perawongmetha/Reuters

“If you didn’t know about this outbreak, you’d read the scan and you would just say, ‘Okay, this patient has pneumonia,’ because that’s the most common thing we see,” Lakhani said.

On its own, he added, ground glass isn’t particularly helpful for identifying a coronavirus.

“You can see it with all types of infections – bacterial, viral, or sometimes even non-infectious causes,” Lakhani said. “Even vaping could sometimes appear this way.”

But the researchers also noticed that the ground-glass patches extend to the edges of the patient’s lungs.

“That’s something we don’t often see,” Lakhani said. “We saw that with severe acute respiratory syndrome (SARS) and we saw that with Middle East respiratory syndrome (MERS).”

Both SARS and MERS are also coronaviruses. An outbreak of the former in China resulted in 8,000 cases and 774 deaths from November 2002 to July 2003.

Lakhani said scans of those viruses have “a lot of similar features” to the images from the 33-year-old patient.

That aligns with other research published this week, which found that the new coronavirus and SARS share about 80% of their genes.

The scans show the virus getting worse after 3 days

The researchers also saw that the white patches on the woman’s lungs were more pronounced in the second image, taken three days after the first – and further into her treatment. That helps rule out pneumonia.

“Pneumonia usually doesn’t rapidly progress,” Lakhani said. “Typically, most hospitals will treat with antibiotics and patients will stabilize and then start to get better.”

In the hospital, the 33-year-old woman in Lanzhou inhaled a protein used to treat viral infections, called interferon. Lakhani guessed that doctors probably also administered “supportive treatment” such as fluids, steroids, or a medication to open the woman’s airways. But she continued to get worse.

That’s significant, Lakhani said, since the same thing occurred in SARS patients.

The best way to diagnose the coronavirus isn’t via scans, though – it’s a laboratory test, which involves taking swabs of saliva or mucus from a patient’s nose and mouth or testing phlegm they may cough up.

But the test isn’t perfect, since it can only detect the virus when a person is showing symptoms.

“We’ve seen people who had a detectable virus, then they didn’t have a detectable virus, and then three days later they had a detectable virus,” Robert Redfield, CDC director said in a briefing last week. “We don’t know the natural history of how this virus is secreted.”

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