The halo sign as a chest computed tomography finding of COVID-19

Farias, Lucas de Pádua Gomes de; Pereira, Helena Alves Costa; Anastacio, Eduardo Pinheiro Zarattini; Minenelli, Fernanda; Teles, Gustavo Borges da Silva

doi:10.31744/einstein_journal/2020ai5742

Cited by 6 publications

(4 citation statements)

References 9 publications

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“…The incidence of halo sign in our study was 0.3%. In current limited research, only few cases reports on the halo sign has been made in COVID-19 [ 11 , 37 , 38 ]. Based on the pathological findings as seen in some recent studies, extensive thrombotic damage of the pulmonary microcirculation can explain the “halo sign” of consolidations [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Spectrum of atypical pulmonary manifestations of COVID-19 on computed tomography

Gurumurthy

Das

Hiremath

et al. 2021

Egypt J Radiol Nucl Med

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Background The typical CT manifestations of COVID-19 pneumonia include ground-glass opacity (GGO) with or without consolidation and superimposed interlobular septal thickening. These are often rounded in morphology and frequently bilateral, multilobar, posterior, peripheral, and basilar in distribution. The various atypical CT features of COVID-19 are seldom described in the literature. The study aims to enumerate the atypical pulmonary CT features in patients with COVID-19 pneumonia in correlation with the disease severity. Results A total of 298 confirmed cases of COVID-19 pneumonia with positive reverse transcription polymerase chain reaction (RT-PCR) who underwent chest CT scans were retrospectively evaluated. The cohort included 234 (78.5%) men and 64 (21.5%) women and the mean age was 53.48 ± 15.74 years. The most common presenting symptoms were fever [n = 197 (66.1%)] and cough [n = 139 (46.6%)]. Out of 298 cases of COVID-19 pneumonia, 218 cases (73.1%) showed typical CT features while 63 cases (21.1%) showed atypical CT features with concurrent classical findings and the remaining 17 cases (5.8%) were normal. Among the atypical CT features, the most common was pulmonary cysts [n = 27 (9%)]. The other features in the order of frequency included pleural effusion [n = 17 (5.7%)], nodules [n = 13 (4.3%)], bull’s eye/target sign[n = 4 (1.3%)], cavitation [n = 3 (1.0%)], spontaneous pneumothorax [n = 2 (0.6%)], hilar lymphadenopathy [n = 2 (0.6%)], spontaneous pneumo-mediastinum with subcutaneous emphysema [n = 1 (0.3%)], Halo sign [n = 1 (0.3%)], empyema [n = 1 (0.3%)] and necrotizing pneumonia with abscess [n = 1 (0.3%)]. Conclusion CT imaging features of COVID-19 pneumonia while in a vast majority of cases is classical, atypical diverse patterns are also encountered. A comprehensive knowledge of various atypical presentations on imaging plays an important role in the early diagnosis and management of COVID-19.

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Section: Discussionmentioning

confidence: 99%

Spectrum of atypical pulmonary manifestations of COVID-19 on computed tomography

Gurumurthy

Das

Hiremath

et al. 2021

Egypt J Radiol Nucl Med

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“…Therefore, clinical data and temporal correlation with radiological findings are extremely important, as well as correlation with previous examination findings. In addition to these findings, CT of patients with COVID-19 may also show signs of organizing pneumonia, reversed halo sign, reticular pattern, subpleural curvilinear lines, parenchymal bands, pseudocavities, and nodules, sometimes configuring the halo sign (17)(18)(19). Airway centered disease such as bronchial wall thickening, centrilobular and tree in bud opacities, pleural effusion, and lymphadenopathy are not frequently encountered at the initial presentation of COVID-19 (17).…”

Section: ' Chest Computed Tomographymentioning

confidence: 99%

Imaging findings in COVID-19 pneumonia

Farias

Fonseca

Strabelli

et al. 2020

Clinics

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The coronavirus disease , caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in Wuhan city and was declared a pandemic in March 2020. Although the virus is not restricted to the lung parenchyma, the use of chest imaging in COVID-19 can be especially useful for patients with moderate to severe symptoms or comorbidities. This article aimed to demonstrate the chest imaging findings of COVID-19 on different modalities: chest radiography, computed tomography, and ultrasonography. In addition, it intended to review recommendations on imaging assessment of COVID-19 and to discuss the use of a structured chest computed tomography report. Chest radiography, despite being a low-cost and easily available method, has low sensitivity for screening patients. It can be useful in monitoring hospitalized patients, especially for the evaluation of complications such as pneumothorax and pleural effusion. Chest computed tomography, despite being highly sensitive, has a low specificity, and hence cannot replace the reference diagnostic test (reverse transcription polymerase chain reaction). To facilitate the confection and reduce the variability of radiological reports, some standardizations with structured reports have been proposed. Among the available classifications, it is possible to divide the radiological findings into typical, indeterminate, atypical, and negative findings. The structured report can also contain an estimate of the extent of lung involvement (e.g., more or less than 50% of the lung parenchyma). Pulmonary ultrasonography can also be an auxiliary method, especially for monitoring hospitalized patients in intensive care units, where transfer to a tomography scanner is difficult.

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“…The ground glass opacity is presumed to represent perinodular alveolar edema and hemorrhage, while the nodule or mass indicate foci of the pulmonary infarction, tumor, or organized inflammatory nodule (11). The halo sign has been reported in several diseases, including other viral pneumonia, angioinvasive pulmonary aspergillosis, Kaposi sarcoma, and adenocarcinoma of the lung, metastasis, and other infections (bacterial, fungi and viral) and inflammatory (granulomatosis with polyangiitis) conditions (12).…”

Section: Halo and Reverse Halo Signmentioning

confidence: 99%

Clarifying Terminology of Signs in COVID-19

Yale¹

2021

Erciyes Med J

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The term "sign" has been used to describe various phenomena observed in patients with coronavirus disease 2019 (COVID-19). Discrepancies in the use of this term have been identified when it is used in context with COVID-19. The goals of this review are to provide an overview, describe signs, and clarify misconceptions regarding the use of these terms in COVID-19 patients. PubMed and Medline databases were searched using individual and Medical Subject Headings (MeSH) terms, including coronavirus, COVID-19, and sign, in human studies within the English literature published from inception to December 31, 2020. Studies where the word "sign" was used in a context different from that for COVID-19 (e.g., sentinel sign) were excluded. Three hundred fifty-seven studies were potentially identified and after applying the exclusion criteria and further adjudication, 92 studies constituted the final data set. The majority of signs found in the COVID-19 literature have been applied and aptly described primarily in radiologic diseases of the chest. The term "sign," in other situations, is often misappropriated as it actually represents a physical finding rather than a sign. A total of 27 radiologic signs have been identified on chest computed tomography (CT) or high-resolution CT (HRCT), and 18 cutaneous signs (or findings) have been observed during the physical examination in COVID-19. Signs lack sufficient sensitivity or specificity by themselves; however, in the appropriate clinical setting, they should raise clinical suspicion for this infectious disease.

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The halo sign as a chest computed tomography finding of COVID-19

Cited by 6 publications

References 9 publications

Spectrum of atypical pulmonary manifestations of COVID-19 on computed tomography

Spectrum of atypical pulmonary manifestations of COVID-19 on computed tomography

Imaging findings in COVID-19 pneumonia

Clarifying Terminology of Signs in COVID-19

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