Although the imaging features of novel coronavirus disease 2019 (COVID-19) are variable and nonspecific, the findings reported thus far do show "significant overlap" with those of severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), according to research.
COVID-19 is diagnosed on the presence of pneumonia symptoms (dry cough, fatigue, myalgia, fever, dyspnea), as well as recent travel to China or known exposure, and chest imaging plays a vital role in both assessment of disease extent and follow-up.
As per her review of the present clinical literature concerning COVID-19, Melina Hosseiny of the University of California – Los Angeles concluded: "Early evidence suggests that initial chest imaging will show abnormality in at least 85% of patients, with 75% of patients having bilateral lung involvement initially that most often manifests as sub-pleural and peripheral areas of ground-glass opacity and consolidation."
Furthermore, "older age and progressive consolidation" may imply an overall poorer prognosis.
Unlike SARS and MERS – where initial chest imaging abnormalities are more frequently unilateral – COVID-19 is more likely to involve both lungs on initial imaging.
"To our knowledge," Hosseiny continued, "pleural effusion, cavitation, pulmonary nodules, and lymph-adenopathy have not been reported in patients with COVID-19." Ultimately, the authors of this article recommended CT for follow-up in patients recovering from COVID-19 to evaluate long-term or even permanent pulmonary damage, including fibrosis – seen in SARS and MERS infections.
Abstract
Objective: Since the outbreak of the novel coronavirus pulmonary illness coronavirus disease 2019 (COVID-19) in China, more than 79,000 people have contracted the virus worldwide. The virus is rapidly spreading with human-to-human transmission despite imposed precautions. Because similar pulmonary syndromes have been reported from other strains of the coronavirus family, our aim is to review the lessons from imaging studies obtained during severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) outbreaks.
Conclusion: The review of experiences with the MERS and SARS outbreaks will help us better understand the role of the radiologist in combating the outbreak of COVID-19. The known imaging manifestations of the novel coronavirus and the possible unknowns will also be discussed.
Authors
Melina Hosseiny, Soheil Kooraki, Ali Gholamrezanezhad, Sravanthi Reddy, Lee Myers
[link url="https://www.sciencedaily.com/releases/2020/02/200228142018.htm"]American Roentgen Ray Society material[/link]
[link url="https://www.ajronline.org/doi/10.2214/AJR.20.22969"]American Journal of Roentgenology abstract[/link]