COVID-19 pneumonia

Case contributed by Antonio Rodrigues de Aguiar Neto


This patient presented to the ER with daily high fever and dry cough, without dyspnea, with the onset of symptoms three days ago.

Patient Data

Age: 40 years
Gender: Male

Day three from symptoms onset


CT did not show signs of pneumonia. 

No pleural effusion, neither enlarged mediastinal lymph nodes.

Follow up CT - day eight from symptoms onset


CT reveals the disease at the progressive stage (stage 2) of COVID-19 pneumonia, showing peripheral bilateral ground-glass opacities (GGOs), some of them superimposed with faint interlobular septal thickening or “crazy-paving” pattern. No consolidation. 

Follow up CT – day eleven from symptoms onset


CT demonstrates the progression of the lung abnormalities to the peak stage (stage 3) of COVID-19 pneumonia, characterized by bilateral ground-glass opacities larger than previous CT, with “crazy-paving” and some small consolidations.

Case Discussion

Covid-19 is a disease caused by SARS-CoV-2, which transmission is primarily human-to-human 1-5. Chest CT may provide valuable information for the diagnostic workup and manage these patients 1-5. Up to 20% of CT scans show no infectious abnormalities at the early stages of the disease 1-5. The most common CT findings include multifocal bilateral ground-glass opacities, a crazy-paving pattern, and patchy consolidation 1-5

This patient with laboratory-confirmed SARS-CoV-2 had a CT negative for pneumonia in the early stage of the disease. Follow-up tomographic examination illustrates the typical CT patterns of COVID-19 pneumonia.

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