Imaging Plays Key Role in Coronavirus Fight

Faced with a critical shortage of resources in heading off the rapid spread of COVID-19 (commonly called “coronavirus”) around the world, health care personnel will rely on imaging as a guide for where monitoring and treatment will be focused, said Dr. Sanjay Jain, director of the Center for Infection and Inflammation Imaging Research at Johns Hopkins University School of Medicine. Most studies associated with COVID-19 have used CT technology to see how it winds its way through the respiratory and digestive systems, but Jain said this is not a diagnostic solution, and it will take other modalities to truly grasp how severe the problem has become among patient groups.

Jain facilitated a webinar sponsored by the World Molecular Imaging Society. He was joined virtually by Dr. Oren Gordon, a pediatric infectious diseases fellow, and Dr. Elizabeth Tucker, who also focuses on pediatric critical care, both at Johns Hopkins University School of Medicine.

Gordon said the nature of the coronavirus was related to SARS, had been imaged at between 60 and 140 nm in diameter, and was made up of four structured proteins.

“Right now, people are scrambling for animal models and noninvasive modalities as tools,” Jain said. “At the Imaging Society, we have been talking for a long time about how infections spread, and the potential for a pandemic has been in everyone’s mind. Yet too little work has been done imaging fungi and viruses.”

Gordon agreed with Jain on the significance of tracking disease progression, adding, “As resources are scarce, and our capacity for testing is still being built, the use of imaging to stratify patients in terms of critical care is crucial.”

As of Friday, more than half a million cases had been identified worldwide, but the trio pointed out that these numbers only reflected who has been tested so far; this means that the actual infection rate is likely considerably higher. That said, there was some good news — 80% of cases were identified with “mild to moderate” symptoms, meaning that a respirator was not required, and pregnant women and their unborn children were no more at risk than other segments of the population. On the other hand, the virus has the potential to both survive on surfaces like plastic for hours and can also be present in a person’s system for days before symptoms appear — thus subjecting those with whom he or she comes into contact with possible infection.

“Like others combating this, we are talking about washing hands and social distancing for the public, and different masks for medical personnel,” Tucker said. “There is no specific treatment, but oxygen is required in severe cases, so the sooner we can identify who needs it, the more we can preserve the ICU beds that are in short supply.”