COVID-19 pneumonia - rapidly progressive

RapidlyCOVID-19 pneumonia - rapidly progressive SARS-CoV-2 (COVID-19) pneumonia

60-year-old male attending the emergency room for feverFever and odynophagia. Trip to Italy 7 days ago. Low oxygen saturation (SpO2 89%) and lymphopenia were observed. The patient presented clinical worsening during his stay in the emergency department, and radiological control was performed at 12 hours. SARS-CoV-2 RNA was detected.

COVIDSARS-CoV-2 infection (COVID-19 infection) can lead to rapidly progressive ARDS as we showshown in this case. The prognosis is poor and radiologic findings can go from ill-defined alveolar consolidations to bilateral consolidationsconsolidation with panlobar affectionchanges as seen in ARDS.

Radiographic and computed tomography (CT) imaging early in the disease course may be normal; chest CT has been described as more sensitive than chest Xx-ray for the detection of characteristic bilateral, peripherally-predominant ground-glass opacities. However, the patient's clinical situation often does not allow a CT scan.

Rapidly progressive SARS-CoV-2 (COVID-19) pneumonia

Radiological stability, with slight improvement of the alveolar consolidation in right lower lobe. The patient still needs supportive care measures.

Three days later

12 hours later

Radiological worsening with patchy, bilateral alveolar consolidation with panlobar opacity suggesting ARDS secondary to COVID19.

On admission

Figure 1 (at admission): FaintFaint, ill-defined alveolar consolidations in both upper lobes.

Figure 2 (12 hours later): Radiological worsening with patchy, billateral alveolar consolidation with panlobar afectation suggesting ARDS secondary to COVID19.

Figure 3 (3 days later): Radiological stability, with slight improvement of the alveolar consolidation in right lower lobe. The patient still needs supportive care measures.