Acute COVID-19 lung disease and long COVID vascular pathophysiology modelling: the relevance of medical imaging in building multidisciplinary understanding

In this review, imaging features of COVID-19 lung disease are analysed in the context of pathophysiological processes in different phases of the disease. Radiological evidence is presented for the central role of vasculopathic phenomena in both the acute and post-acute phases of COVID-19. Radiologists have a central role in building understanding of many diseases. In multidisciplinary settings, medical imaging has a role in diagnosing, assessing severity, monitoring progress and delineating anatomy involved in diseases. Imaging also helps to elucidate models of disease pathogenesis. At the outset of the COVID-19 pandemic many groups worked together informally to gain understanding of pathogenesis, but no centralised system for formal interdisciplinary collaboration existed. In hindsight, the absence of formalised radiological involvement in building models of pathophysiology potentially contributed to the use of terminology which may be considered inappropriate or misleading. We reflect on the use of certain terminology commonly used to describe the lung disease. In conclusion, imaging is essential to multidisciplinary understanding of COVID-19 vascular pathophysiology both in the acute and post-acute phases of disease. Formation of collaborative systems to build interdisciplinary understanding of disease pathogenesis across all medical and scientific specialties should be a priority at the outset of any future pandemic.