Answers to Your Top 6 Questions on White Lungs

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With the soaring number of COVID-19 confirmed cases in China since December 2022, many patients have developed “white lung,” severe pneumonia with bilateral lung lesions reaching 75 percent or more.

1. What Is “White Lung” and What Are the Symptoms?

“White lung” refers to a manifestation seen on chest X-rays and CT scans in cases of severe pneumonia. For a healthy person, in a chest X-ray or CT scan, the lungs appear black because they contain air. But when the lungs are severely infected or acutely injured, the tiny air sacs (alveoli) and capillaries in the lungs are damaged, and blood and fluid leak into the spaces between the air sacs and eventually into the air sacs, causing the alveoli to collapse. This is when patchy white shadows appear on the image; the lungs appear white, hence the term white lung.

When this happens, alveolar fluid builds up, and blood oxygen levels drop precipitously. When most alveoli collapse, oxygen cannot enter the bloodstream. Clinical manifestations include chest tightness, shortness of breath, poor breathing, and blood oxygen saturation of less than 93 percent. Symptoms such as cyanotic complexion (a bluish appearance), sweating, rapid heartbeat, and cognitive confusion may occur.

2. Is White Lung Unique to the COVID-19 Virus?

Any condition or disease that causes acute damage to the lungs, including bacterial infection, seizure, aspiration pneumonia, mycoplasma pneumonia, and chest trauma (lung contusion), may cause white lung.

3. How Do You Know If You Have White Lung?

The most important thing is to check whether there is shortness of breath and whether the blood oxygen level is normal. If it is lower than 93 percent, you should suspect that you have pneumonia. You may go to the hospital for a further examination.