Presentation
Fever, cough, breathing difficulties for about seven days.
Patient Data
There are large areas of ground-glass opacities in all lung lobes, with interlobular septal thickening (crazy-paving) and bilateral consolidations with air bronchogram in the posterior segment of lower lobes. Only a few lung areas are preserved.
Right-sided segmental and subsegmental pulmonary arterial filling defects in keeping with acute distal pulmonary emboli.
Right-sided segmental and subsegmental pulmonary arterial filling defects (yellow arrows) in keeping with acute distal pulmonary emboli.
Case Discussion
This patient had positive RT-PCR testing for COVID-19 and was admitted to the intensive care unit with acute respiratory distress syndrome (ARDS) and pulmonary thromboembolism.
COVID-19 infection can lead to rapidly progressive ARDS as we show in this case 1.
Initial CT findings in COVID-19 include: 2,3
- bilateral, multilobar ground glass opacification (GGO) with a peripheral or posterior distribution, mainly in the lower lobes and less frequently in the middle lobe
- sometimes there are thickened interlobular and intralobular lines in combination with a ground-glass pattern (crazy paving); it is believed that this pattern is seen in a somewhat later stage
There is much overlap of the CT-pattern of COVID-19 with other viral pneumonias.
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