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26 maart 2020

An update on CT chest findings in coronavirus disease-19 (COVID-19) - 19 Heart and Lung

Bron: 20-03-2020; https://doi.org/10.1016/j.hrtlng.2020.03.007
By: K. Kant Sahu et al. 

Aim
Summarize recent literature on CT-findings in COVID19

Key

  • See table for corona signs on CT
  • These signs are however general for infectious pulmonary disease and not pathognomonic for covid19

Summary

  • Bernheim et al.: relationship to duration of infection. Radiology. 0(0):200463.) outlined ct-findings of 121 patients in relation to time between onset of symptoms and ct. 
    • Three groups: early group (ct in day 0-2 after symptoms), intermediate (3-5 days), late (6-12 days). 
    • 56% of early group had normal ct
    • the longer the interval between symptoms and ct scan, the larger the chance of visible abnormalities and bilateral involvement. 
    • Lower lobes most often involved (+- 65%)
  • Wu et al. 
    • Mostly right lower lobe (80-86%). Most often bilateral involvement
  • Signs on CT;
  • However, the signs above are quite general and can also be seen in pneumonia or other inflammatory pulmonary diseases or heart failure. Differences between corona and these etiologies have not yet been described
  • Differences between ventilated and non-ventilated patients are also important given the effect positive pressure ventilation can have. 
  • As of now, it seems that COVID-19 lacks any specific or pathognomonic CT findings limiting its utility for complete reliability and bedside application.