When pneumonia is not COVID-19

Arenas, Juan; Plasencia-Martínez, J.M.; García‐Garrigós, Elena

doi:10.1016/j.rxeng.2020.11.003

Cited by 9 publications

(6 citation statements)

References 69 publications

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“…Having said that, we stress that our patient showed an indeterminate or atypical appearance of radiological signs for COVID-19 pneumonia in both X-ray and CT studies, conforming to the medical literature [ 14 , 16 - 18 ]⁠. It is worth noting a recent paper discussing atypical radiological findings that make it necessary to widen the spectrum of alternative diagnoses [ 19 ]⁠.…”

Section: Discussionsupporting

confidence: 84%

Delayed Diagnosis of an Atypical Pneumonia Resembling a Solitary Pulmonary Nodule

García-Carretero¹,

Vázquez-Gómez²,

Rodriguez-Maya³

et al. 2021

Cureus

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Atypical pneumonia shows clinical features that are different from those of typical pneumonia, and it can mimic other entities. We report the case of a 42-year-old male with a solitary pulmonary nodule found in an X-ray for a preoperative evaluation. Our patient was asymptomatic, and a pulmonary neoplasm was the first diagnostic suspicion. The round-shaped nodule seen in the X-ray turned out to be a linear ground glass opacity in a thoracic CT scan. Viral pneumonia due to SARS-CoV-2 was diagnosed. We emphasize here the educational value of this case report. We do not report a new radiological finding because lung nodules resembling neoplasms have already been reported in the medical literature. However, some clinical features of COVID-19 are relatively new and can mimic other entities, and the results of some investigations and clinicians’ interpretations of them can be misleading. Atypical radiological findings make it necessary to widen the spectrum of alternative diagnoses.

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Section: Discussionsupporting

confidence: 84%

Delayed Diagnosis of an Atypical Pneumonia Resembling a Solitary Pulmonary Nodule

García-Carretero¹,

Vázquez-Gómez²,

Rodriguez-Maya³

et al. 2021

Cureus

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“…The first published studies of children reported few findings in radiographs; 15 however, subsequent reports have revealed a higher proportion of radiographic abnormalities, 11 which depend on the severity of pulmonary involvement. 31 , 32 In adults, most computed tomography studies in SARS‐CoV‐2‐associated CAP show ground‐glass opacities (25%–60% according to different studies), 33 , 34 , 35 , 36 , 37 , 38 which can progress to white lung. The proportion of white lung in children is low and the mechanism is worth further study.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…The radiological presentation of SARS‐CoV‐2 can be nonspecific and indistinguishable from other pathologies. The first published studies of children reported few findings in radiographs; 15 however, subsequent reports have revealed a higher proportion of radiographic abnormalities, 11 which depend on the severity of pulmonary involvement 31,32 . In adults, most computed tomography studies in SARS‐CoV‐2‐associated CAP show ground‐glass opacities (25%–60% according to different studies), 33–38 which can progress to white lung.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of pneumonia features in children caused by SARS‐CoV‐2 and other viral respiratory pathogens

Valle-Pérez

Ballesteros

Calvo

et al. 2022

Pediatric Pulmonology

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Background Pneumonia is a frequent manifestation of coronavirus disease 2019 (COVID‐19) in hospitalized children. Methods The study involved 80 hospitals in the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) Spanish Pediatric National Cohort. Participants were children <18 years, hospitalized with SARS‐CoV‐2 community‐acquired pneumonia (CAP). We compared the clinical and radiological characteristics of SARS‐CoV‐2‐associated CAP with CAP due to other viral etiologies from ValsDance (retrospective) cohort. Results In total, 151 children with SARS‐CoV‐2‐associated CAP and 138 with other viral CAP were included. Main clinical features of SARS‐CoV‐2‐associated CAP were cough, fever, or dyspnea. Lymphopenia was found in 43% patients and 15% required admission to the pediatric intensive care unit (PICU). Chest X‐ray revealed condensation (42%) and other infiltrates (58%). Compared with CAP from other viral pathogens, COVID‐19 patients were older, with lower C‐reactive protein (CRP) levels, less wheezing, and greater need of mechanical ventilation (MV). There were no differences in the use of continuous positive airway pressure (CPAP) or HVF, or PICU admission between groups. Conclusion SARS‐CoV‐2‐associated CAP in children presents differently to other virus‐associated CAP: children are older and rarely have wheezing or high CRP levels; they need less oxygen but more CPAP or MV. However, several features overlap and differentiating the etiology may be difficult. The overall prognosis is good.

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“…The radiological presentation of SARS-CoV-2 can be non-specific and indistinguishable from other pathologies. The first published studies of children reported few findings in radiographs 15 ; however, subsequent reports have revealed a higher proportion of radiographic abnormalities 11 , which depend on the severity of pulmonary involvement 31,32 . In adults, most computed tomography studies in SARS-CoV-2-associated CAP show ground-glass opacities (25-60% according to different studies) [33][34][35][36][37][38] that can progress to white lung.…”

Section: Discussionmentioning

confidence: 99%

Comparison of pneumonia features in children caused by SARS-CoV-2 and other viral respiratory pathogens.

Valle-Pérez

Ballesteros

Calvo

et al. 2021

Preprint

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Pneumonia is a frequent manifestation of COVID-19 in hospitalized children. Methods The study involved 80 hospitals in the SARS-CoV-2 Spanish Pediatric National Cohort. Participants were children <18 years, hospitalized with SARS-CoV-2 community-acquired pneumonia (CAP). We compared the clinical characteristics of SARS-CoV-2-associated CAP with CAP due to other viral etiologies from 2012 to 2019. Results In total, 151 children with SARS-CoV-2-associated CAP and 138 with other viral CAP included. Main clinical features of SARS-CoV-2-associated CAP were cough 117/151(77%), fever 115/151(76%) and dyspnea 63/151(46%); 22/151(15%) patients were admitted to a pediatric intensive care unit (PICU), and 5/151(3%) patients died. Lymphopenia was found in 63/147(43%) patients. Chest X-ray revealed condensation (64/151[42%]) and other infiltrates (87/151[58%]). Compared with CAP from other viral pathogens, COVID-19 patients were older (8 vs.1 year; odds ratio [OR] 1.42 [95% confidence interval, CI 1.23;1.42]), with lower CRP levels (23 vs.48 mg/L; OR 1 [95%CI 0.99;1]), less wheezing (17 vs.53%; OR 0.18 [95%CI 0.11;0.31]) and greater need of mechanical ventilation, MV (7 vs.0.7%, OR 10.8 [95%CI 1.3;85). Patients with non-SARS-CoV-2-associated CAP had a greater need for oxygen therapy (77 vs.44%, OR 0.24 [95%CI 0.14;0.40]). There were no differences in the use of CPAP or HVF or PICU admission between groups. Conclusion SARS-CoV-2-associated CAP in children presents differently to other virus-associated CAP: children are older and rarely have wheezing or high CRP levels; they need less oxygen but more CPAP or MV. However, several features overlap, and differentiating the etiology may be difficult. The overall prognosis is good.

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When pneumonia is not COVID-19

Cited by 9 publications

References 69 publications

Delayed Diagnosis of an Atypical Pneumonia Resembling a Solitary Pulmonary Nodule

Delayed Diagnosis of an Atypical Pneumonia Resembling a Solitary Pulmonary Nodule

Comparison of pneumonia features in children caused by SARS‐CoV‐2 and other viral respiratory pathogens

Comparison of pneumonia features in children caused by SARS-CoV-2 and other viral respiratory pathogens.

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