Are the "white lung" and myocarditis caused by the new coronavirus really hidden killers of young and middle-aged people?

The main public anxiety about the coronavirus has previously focused on the elderly and sick at home. But recently, a series of cases have fermented on social media, all pointing to two seemingly more dangerous "hidden killers" of the coronavirus: "white lung" and myocarditis.

According to these cases, the symptoms of both phenomena are vague and difficult to detect, but the targets of attack are not limited to the elderly. Young people with no underlying diseases can also be affected and die within a short period of time.

Are these claims true? Are “white lung” and myocarditis really as silent and deadly as rumored?

What is "white lung"?

First of all, “white lung” is not a rigorous term; pneumonia is not equal to “white lung”, nor is it equal to severe illness and death.

Most of the lungs are alveoli, which are filled with air. Under normal circumstances, when a CT scan of the lungs is taken, the radiation can pass through, so it appears black. However, when the lungs are inflamed, the exudate and inflammatory cells will block the radiation, making the inflamed part appear white.

"White" will appear when there is inflammation in the lungs, and due to the different degrees of inflammation, the size and shape of the "white" will also vary greatly.

The following pictures are from "Early Signs and Differential Diagnosis of New Coronavirus Pneumonia CT" and are real pictures collected clinically in 2020.

The mild pneumonia caused by the new coronavirus infection is only as small as the red arrow in the picture indicates:

As pneumonia progresses, the white areas increase in number and size:

So, will these disease manifestations persist?

In fact, most people don’t.

As long as it does not reach the level of severe or critical illness, pneumonia caused by the new coronavirus infection is mostly reversible. The following picture is from a 21-year-old patient. Although he had pneumonia, the degree of infection was not serious. Within half a month, most of the lesions disappeared on their own:

In similar cases, it may take three months to two years for the lungs to fully recover. If the pneumonia is more severe, it may also leave certain cord-like scars.

The picture below is the real "white lung". In the severe stage, the lung shadow turns white over a large area, which is a very dangerous image of acute respiratory distress syndrome, often accompanied by low blood oxygen and viral infection in blood routine. If not intervened in time, the mortality rate is high.

At this point, even people without a medical background can see a big difference - the lungs have "turned white", which is why this phenomenon is commonly known as "white lungs".

This situation mainly occurs in the elderly and people with underlying diseases, and is less common in young people.

The above pictures were all taken in 2020, and the main epidemics were the more dangerous original strains and alpha strains. However, similar lung imaging changes do not only occur in novel coronavirus infections. Pneumonia caused by various bacteria, influenza A, and even the common cold (rhinovirus) can also show similar "white patches", which need to be carefully distinguished.

The Omicron strain is relatively more capable of causing upper respiratory tract infections, but less capable of causing pneumonia, and at a lower rate. This information is often distorted by the self-media into "not causing pneumonia", which is undoubtedly wrong, but the occurrence of a certain proportion of severe pneumonia does not necessarily mean that the original strain or Delta strain has made a comeback.

In fact, even if only 1% of cases have lung symptoms and 1% of cases have true "white lungs", considering the current huge number of infections, a city with a population of tens of millions may have thousands of people rushing to the hospital every day, and many people may die from pneumonia. With the development of the Internet today, these cases can easily spread on social media.

At present, there is no statistics on COVID-19-related "white lung" and pneumonia in China (and basically no data is counted at all), so we cannot estimate what proportion of these images appear.

There is also a medical speculation that many cases of COVID-19 "white lung" may be caused by bacterial infection, especially in the elderly. The imaging patterns of many cases can reflect this, which can also partially explain the phenomenon of "nurses are more likely to have it" mentioned in a screenshot, because hospitals are the base camps of many bacteria.

Nowadays, there are many cases of "white lung" circulating on social media, and it is difficult to distinguish the true from the false, but some milder pneumonia cases similar to the second, third and fourth pictures may be confused. If this situation does not tend to turn into a severe case, most of them can gradually improve, and there is no specific medicine that can guarantee a cure. Even if a real "white lung" occurs, if the medical conditions can keep up, with the support of ventilators, ECMO and other means, there is a certain hope of saving lives, but it may cause long-term effects on lung function.

"White lung", or acute respiratory distress syndrome, usually develops quickly, no more than a week after the original disease. The most important sign is a sudden drop in blood oxygen. A drop below 93% requires attention, while a drop below 90% or even below 80% is very dangerous. At the same time, it is often accompanied by symptoms such as chest tightness, difficulty breathing, and mental depression.

Yesterday, the topic of "Should I take a CT scan after COVID-19" became a hot search topic. From a practical point of view, this largely depends on whether the medical resources in your area are tight, whether you can get a CT scan, or whether the cost of taking a CT scan is greater than the guidance it brings to you.

If you need to take a CT scan, it is recommended. For mild pneumonia, the chest X-ray may not be able to show it clearly.

What is myocarditis?

From the perspective of ordinary people, myocarditis itself is a somewhat mysterious disease. There are many factors that can induce it, including infectious diseases such as colds and flu, bacteria, fungi, parasitic infections, autoimmune diseases, allergies, adverse drug reactions, long-term fatigue and lack of sleep... etc. So it is not surprising that the new coronavirus can induce myocarditis.

In fact, myocarditis is quite common. Before COVID-19, it was estimated that there were 1 to 10 cases per 100,000 people each year. Mild myocarditis may not show any symptoms and can be fully recovered after rest, so perhaps you have had it without knowing it and have recovered long ago.

But the same myocarditis can be very serious when it becomes severe, causing heart failure or even sudden death within a week or two of the onset of the disease. It may also lead to chronic cardiomyopathy and cause long-term effects on heart function.

As early as 2020, there were reports in the academic community that COVID-19 infection induced myocarditis. Although it is relatively rare, it is indeed possible. The evidence-based medicine website UpToDate made a detailed summary of this, confirming that the incidence of myocarditis after COVID-19 infection has indeed increased significantly.

This type of myocarditis is quite special. Anatomy has failed to confirm that the new coronavirus directly causes myocarditis, so it is different from the "viral myocarditis" often mentioned in the past. Current research tends to believe that it is caused by micro-ischemia.

However, for ordinary people, the exact principle is not important. **The new crown is indeed related to myocarditis. **According to data from the US Centers for Disease Control and Prevention, the incidence of myocarditis has soared since March 2020, with approximately 146 cases per 100,000 people per year. Among them, some may be caused by mRNA vaccines, and myocarditis is a relatively rare adverse reaction after vaccination.

Men, people over 50 years old, and children under 16 years old are at higher risk. In this sense, myocarditis is indeed a silent killer of young people, but it is not so easy to appear.

146 per 100,000 is not considered a high incidence rate, but considering China's huge population base, the country may still see tens of thousands of additional cases of COVID-related myocarditis within a year, or even more.

The normal heart rate in a calm state is 60 to 100 beats per minute. If you have a fever, it is normal for your heart rate to increase by 12 beats per minute for every degree increase in body temperature. If your heart rate after COVID-19 infection is much higher than this level, or you have palpitations, chest pain, discomfort in the precordial area, shortness of breath, etc., it indicates that you may have myocarditis and you need to go to the hospital as soon as possible.

Avoid strenuous exercise or overwork within 2 to 3 weeks after COVID-19 infection, and drink less caffeinated beverages. These reminders also need to be heeded.

Mild myocarditis can be cured with plenty of rest and nutritional supplements, and no special treatment is needed. The main danger lies in more serious myocarditis, which must be discovered and treated promptly, otherwise it may really cost your life.

Source: Snake Staff Observer