Chest CT features of coronavirus disease 2019 (COVID-19) pneumonia: key points for radiologists

Abstract

COVID-19 is an emerging infection caused by a novel coronavirus that is moving so rapidly that on 30 January 2020 the World Health Organization declared the outbreak a Public Health Emergency of International Concern and on 11 March 2020 as a pandemic. An early diagnosis of COVID-19 is crucial for disease treatment and control of the disease spread. Real-time reverse-transcription polymerase chain reaction (RT-PCR) demonstrated a low sensibility, therefore chest computed tomography (CT) plays a pivotal role not only in the early detection and diagnosis, especially for false negative RT-PCR tests, but also in monitoring the clinical course and in evaluating the disease severity. This paper reports the CT findings with some hints on the temporal changes over the course of the disease: the CT hallmarks of COVID-19 are bilateral distribution of ground glass opacities with or without consolidation in the posterior and peripheral lung, but the predominant findings in later phases include consolidations, linear opacities, "crazy-paving" pattern, "reversed halo" sign and vascular enlargement. The CT findings of COVID-19 overlap with the CT findings of other diseases, in particular the viral pneumonia including influenza viruses, parainfluenza virus, adenovirus, respiratory syncytial virus, rhinovirus, human metapneumovirus, etc. There are differences as well as similarities in the CT features of COVID-19 compared with those of the severe acute respiratory syndrome. The aim of this article is to review the typical and atypical CT findings in COVID-19 patients in order to help radiologists and clinicians to become more familiar with the disease.

Kawasaki disease in pediatric isolation ward during COVID-19 pandemic

“…However, the incidence of Kawasaki disease during COVID-19 pandemic was signi cantly higher than that before COVID-19 pandemic, and Kawasaki disease associated with abnormalities of chest CT were also signi cantly increased. As shown in gure 1, ground-grass opacity (GGO) which is the initial chest CT feature of COVID -19 has not been found in our current cohort, but pleural thickening, brous strips, and subpleural nodules which are the follow-up chest CT changes of COVID-19 have been observed [32,33]. SARS-CoV-2 RT-PCR test results of pharyngeal swab specimens are variable and potentially unstable [34], the false-negative rate is as high as 66% on day 21 after infection [35].…”

Are there overlapping clinical features between thoracic radiotherapy side effects and covid-19 pneumonia? Radiation pneumonitis outside the radiation ports: Three case reports

“…These syn-72 dromes are rare clinical events that share a febrile flu-like syn-73 drome or respiratory failure illness, such as COVID-19 74 pneumonia, with fever, cough, and dyspnoea. In contrast to classic 75 radiation pneumonitis, in these cases, CT images provide findings 76 that do not correspond with the radiation ports and mimic the 77 wide pictorial fashion of features shown in COVID-19 pneumonia, 78 including the bilateral distribution of ground glass opacities with 79or without consolidation in the posterior and peripheral lung[6].…”

How COVID-19 pandemic has changed haematological care

“…We included all consecutive adult patients with a hematologic disease and a COVID-19 infection. Diagnosis should be based on a on a real-time RT-PCR assay of a specimen collected on a nasopharyngeal swab, or suspected on a chest CT-scann according to recommendation (4) . Every patients had more than 10 days of follow-up.…”