CT - Chest
Axial lung window
Axial non-contrast
Coronal lung window
Which are the CT stages of COVID-19?
The four CT stages of COVID 19 are: early/initial stage (0-4 days), which is characterized by CT without lung abnormalities or ground-glass opacities; progressive stage (5-8 days), which shows increased ground-glass opacities and crazy paving appearance; peak stage (9-13 days), which manifests with consolidations; and absorption stage (>14 days) with an improvement in the lung disease, fibrous stripes may appear, and the abnormalities resolve at one month and beyond.
Which are the categories for standardized CT reporting language of COVID-19?
The consensus statement classifies the CT appearance of COVID-19 into four categories: typical appearance, indeterminate appearance, atypical appearance, and negative for pneumonia.
What characterizes the typical CT appearance of COVID-19?
The typical CT appearance is the presence of peripheral, bilateral, ground-glass opacities with or without consolidations, and crazy paving pattern, associated or not with air space consolidation, reverse halo sign, or other findings of organizing pneumonia.
What characterizes the indeterminate CT appearance of COVID-19?
The indeterminate CT features are the absence of typical CT findings and the presence of multifocal, diffuse, perihilar, or unilateral ground-glass opacities with or without consolidations lacking a specific distribution and are non-rounded or non-peripheral. Also the presence of a few very small ground-glass opacities with a non-rounded and non-peripheral distribution.
What characterizes the atypical CT appearance of COVID-19 pneumonia?
The following CT findings characterize the atypical CT appearance of COVID-19 pneumonia: the absence of indeterminate or typical features; he presence of isolated lobar or segmental consolidation without ground-glass opacities; discrete small nodules (centrilobular, tree-in-bud); lung cavitation; smoother interlobular septal thickening, and pleural effusion.
What characterizes the negative for pneumonia CT appearance of COVID-19?
The negative for pneumonia CT appearance is characterized by no CT features to suggest pneumonia, in particular, absent ground-glass opacities and consolidations.
Which is the treatment for COVID-19?
No specific treatment or vaccine exists for COVID-19 currently. It is necessary to implement public health measures to reduce the transmission of these interhuman viruses. Specific antiviral therapies for COVID-19 do not currently exist. Treatment with chloroquine hydroxychloroquine and a combination with the antibiotic azithromycin has a beneficial effect on the clinical outcome. The antiparasitic ivermectin has attracted the attention of the scientific community for the treatment of COVID-19. Treatment with convalescent plasma from patients who have recovered from COVID-19 has shown some success in some critically ill patients.
What is the estimated mortality rate for COVID-19?
The mortality rate is estimated to be 3,6%.
What are some risk factors that contribute to poor prognosis?
Some risk factors that contribute to poor prognosis are male gender, advanced age, presence of comorbidities (cardiovascular disease, diabetes mellitus, hypertension, chronic respiratory disease, cancer, and immunosuppression), people in a long-term care facility/nursing home. There are some patient conditions and laboratory values at hospital admission that also influence in poor outcome as high sequential organ failure assessment score, D-dimer levels greater than one ug/ml, elevated levels of IL-6, troponin I, lactate dehydrogenase, and lymphopenia.
CT reveals multifocal and bilateral patchy areas of ground-glass opacities scattered in both lungs, predominantly at peripheral, and posterior regions, some of them showing discrete crazy-paving, associated with rare airspace consolidations.
No significant mediastinal lymphadenopathy.
No pericardial or pleural effusion.