A 75-year-old male who was confirmed as suffering of severe COVID pneumonia was transferred
to the intensive care unit (ICU) of our hospital—a tertiary teaching hospital of a
medical university. He had a history of 10-year hypertension and one-year diabetes.
A physical examination unveiled that his body temperature was 35.5 ℃, his pulse was
54 beats per minute, his blood pressure was 136/79 mm Hg (noradrenaline 0.2 µg/kg/min),
his oxygen saturation was 91% (noninvasive ventilation), and oxygenation index (OI:
PO2/FiO2) 100 mmHg. He was diagnosed with severe COVID-19 pneumonia combined with
acute respiratory distress syndrome (ARDS), septic shock, and multiple organ dysfunction
syndrome (MODS). We focused on the typical imaging feature of chest CT in the patient
(Fig. 1). The white “Septal Line” marked by the red arrow in Fig. 1 (Panel a–d) suggests
that cellulosic exudation occurred in the surface of lung lobes. In dynamic imaging,
these white lines are clearly visible, which provides evidence for us to judge severe
COVID-19 pneumonia. In the three-dimensional imaging system, three-dimensional reconstruction
of bilateral lung lesions provided a key clue for early identification of the disease.
Presently, his condition is relatively stable.
Chest computed tomography and three-dimensional reconstruction of the patient's lungs.
Shown are chest CT scans obtained at admission (onset the fifth day) in the local
hospital: Chest computed tomography (CT) scan (a, b, c, d) red arrows denote “Septal
Line” formed by cellulosic exudation between lung lobes; three-dimensional reconstruction
(e, f) green arrows denote multilobed lesions of bilateral lungs