Review of radiographic findings in COVID-19

Abstract

The purpose of this study is to review the published literature for the range of radiographic findings present in patients suffering from coronavirus disease 2019 infection. This novel corona virus is currently the cause of a worldwide pandemic. Pulmonary symptoms and signs dominate the clinical picture and radiologists are called upon to evaluate chest radiographs (CXR) and computed tomography (CT) images to assess for infiltrates and to define their extent, distribution and progression. Multiple studies attempt to characterize the disease course by looking at the timing of imaging relative to the onset of symptoms. In general, plain CXR show bilateral disease with a tendency toward the lung periphery and have an appearance most consistent with viral pneumonia. Chest CT images are most notable for showing bilateral and peripheral ground glass and consolidated opacities and are marked by an absence of concomitant pulmonary nodules, cavitation, adenopathy and pleural effusions. Published literature mentioning organ systems aside from pulmonary manifestations are relatively less common, yet present and are addressed in this review. Similarly, publications focusing on imaging modalities aside from CXR and chest CT are sparse in this evolving crisis and are likewise addressed in this review. The role of imaging is examined as it is currently being debated in the medical community, which is not at all surprising considering the highly infectious nature of Severe Acute Respiratory Syndrome coronavirus 2.

Discrepancies in the clinical and radiological profiles of COVID-19: A case-based discussion and review of literature

“…However, many of the imaging findings in COVID-19 can be nonspecific, and there can be occasional discrepancies between the imaging and clinical features seen in these patients[ 7 , 8 ]. Moreover, on occasions, extrapulmonary disease may dominate in some patients, and pre-existing major illnesses (such as heart failure, liver diseases, chronic kidney disease and malignancies) with the acquisition of COVID-19 illness may pose additional diagnostic dilemmas[ 9 - 14 ].…”

Highlighting COVID-19: What the imaging exams show about the disease

“…Despite the sparse data in the literature on radiography in the COVID-19 context[ 34 ], the consolidation is the most common finding in the radiographs of infected patients, being predominantly observed in peripheral areas of the lower zones[ 35 ], with a peak of severity 10-12 d after the onset of symptoms[ 36 ]. Among 9 patients in Korea, the CXR detected parenchymal abnormalities in three of them, most with peripheral consolidation that was later confirmed by CT[ 37 ].…”

Remote ischemic conditioning for acute respiratory distress syndrome in COVID-19

“…It has been reported that >80% of nonsurviving patients suffer from ARDS and/or respiratory failure, often with associated cardiovascular injury ( 3 – 6 ). The lungs of patients with COVID-19 are subject to interstitial mononuclear cell infiltration and edema ( 7 , 8 ), characteristic outcomes in ARDS ( 9 ).…”