![]() ![]() In a recent study, we were able to demonstrate the involvement of the secondary pulmonary lobules in the fatal trajectory of COVID-19 using ultra-high resolution synchrotron radiation based hierarchical phase-contrast tomography (HiP-CT) ( figure 1a–c). Although COVID-19 related hypoxaemia is characterised by preserved oxygen saturation, a ventilation–perfusion mismatch and increased alveolar ventilation/perfusion ratio heterogeneity, the underlying morphological evidence of this physiological enigma has not been fully understood. We are grateful for them sharing their valuable functional blood and alveolar gas exchange data, pointing out a significant alveolar dead space of nearly 30% in recovered COVID-19 patients, suggesting a persistent pulmonary vascular pathology. describing the role of intrapulmonary shunting and alveolar dead space in patients with acute COVID-19 pneumonitis. With the greatest interest we read the paper by H arbut et al.
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