Characteristic patterns of SARS-CoV-2 on chest CT suggests a hematologic pathway for viral entry into the lung.

Many SARS-CoV-2 studies have supported the theory that the Type II alveolar epithelial cells (AEC-2) are the primary portal of entry of the virus into the lung following its brief nasal occupation. However, the theory of inhalational transmission of the virus from the ciliated and goblet nasal cells to the lung parenchyma is not supported by the imaging findings on chest computerized tomography (CT), leading the authors to consider an alternative pathway from the nose to the lung parenchyma that could explain the peripheral, basilar predominant pattern of early disease. Imaging supports that the pulmonary capillaries may be an important vehicle for transmission of the virus and/or associated inflammatory mediators to the lung epithelium. • Imaging supports that the pulmonary capillaries may be important for transmission of the virus and/or inflammatory mediators to the lung epithelium. • SARS-CoV-2 is about 0.1 microns, however, respiratory droplets are generally 5 microns. The nose would be highly effective at retaining respiratory droplets containing the virus. • spread of virus from endothelium to epithelium explains the vulnerability of those with endothelial instability to worse outcomes and supports stabilizing the vascular endothelium. [ABSTRACT FROM AUTHOR]