COVID-19 pneumonia

Case contributed by Roma Patel


Worsening dyspnea. Past history of COPD. T2DM. Previous pancreatectomy. ETOH excess. Lymphopenia on admission.

Patient Data

Age: 85 years
Gender: Male

Chest radiograph on admission demonstrates bilateral, almost symmetrical areas of peripheral consolidation with perihilar infiltrates and an indistinct left heart border. In an endemic area, appearances are highly suggestive of COVID-19. 

The patient underwent a CTPA three days later for subsequent deterioration with hypoxia. 

Three days later


Single slice axial acquisition in the lung windows demonstrates 'classical' appearances of subpleural organizing areas of consolidation with patchy peripheral ground-glass opacities.

Appearances represent a severe case of COVID-19 pneumonia. 

Case Discussion

An elderly patient with multiple co-morbidities. 

Chest radiograph suspicious of COVID-19, which was later PCR confirmed.

Peripheral predominance and progression to organizing pneumonia are currently a well-recognized finding in COVID-19. 

In cases of clinical deterioration where other causes are thought likely (such as a pulmonary embolus), CT imaging is indicated. Otherwise, chest radiographs are thought appropriate to monitor progress.

Lymphopenia on admission may increase the pre-test probability in COVID-19. 

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