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COVID-19: CT Findings

Audience: Radiology Residents, Radiologists, and other Medical Professionals Recommended playback speed: 1.25 to 1.5 Learning Objectives: -Identify and describe the spectrum of findings in viral pneumonia -Explain a basic algorithm for managing patients with suspected viral pneumonia in a radiology department Note: CT is not recommended for screening or diagnosis of COVID-19 pneumonia by The American College of Radiology or the Society of Thoracic Radiology. CT should only be used when indicated by the severity of the patients symptoms. Summary: The Findings are non-specific with CT showing a pattern of acute lung injury (organizing pneumonia) There is a broad differential diagnosis: -Viral pneumonia (Influenza A, influenza B, RSV, coronavirus, rhinovirus, parainfluenza, and adenovirus) -Bacteria pneumonia (Legionella, mycoplasma) -Drug induced (chemotherapy, immunotherapy) -Cryptogenic organizing pneumonia New consensus statement, directly quoted: " Essentials ■ Imaging is not indicated in patients with suspected COVID-19 and mild clinical features unless they are at risk for disease progression. ■ Imaging is indicated in a patient with COVID-19 and worsening respiratory status. ■ In a resource-constrained environment, imaging is indicated for medical triage of patients with suspected COVID-19 who present with moderate-severe clinical features and a high pre-test probability of disease" https://pubs.rsna.org/doi/10.1148/rad... Clinical context is key with specificity dependent on a high pretest probability: Symptoms of COVID-19: Fever, shortness of breath, cough, fatigue, no rhinorrhea (runny nose) Please Wash Your Hands (for 20 seconds and more frequently than in the past) Do Not Touch Your Face (Touching a contaminated surface and then you face is a primary route of spread). If you are over 60 y/o (or under 60 with high blood pressure, diabetes, or cardiovascular disease), consider staying at home, and avoiding groups, crowds, and travel. Comprehensive collection of COVID-19 related radiology articles: https://pubs.rsna.org/2019-ncov Kentucky webpage for up to date information on Local COVID-19: https://kycovid19.ky.gov References: Ai, Tao, et al. "Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: A report of 1014 cases." Radiology (2020): 200642. Bernheim, Adam, et al. "Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Duration of Infection." Radiology (2020): 200463.