Chest imaging features of COVID-19 pneumonia
subject: Chest imaging, COVID-19
description: On 18th of April 2020, a 49-year-old woman developed a fever of 38.40C, with no other symptoms. After taking oral nonsteroidal anti-inflammatory agents for 2 days, the temperature returned to normal. On 20th of April 2020, she complained of persistent dry cough, sore throat, ageusia, anosmia and chest distress. The next day, she presented to the Emergency Department of Arges County Hospital, Pitesti, Romania. She divulged that she had been in close contact with a friend, who had been recently confirmed with the diagnosis of COVID-19. A high-resolution computed tomography (CT) of the chest was performed, that revealed multiple images of patchy ground-glass opacities in bilateral lower lobes (Figure 1).Given the close contact history and imaging findings, she was admitted as a suspected case of SARS-CoV-2 infection. On admission, physical examination unveiled normal vital signs, with oxygen saturation of 96% while breathing ambient air, lung auscultation normal. The antigen test for influenza was negative. Arterial blood gas analysis pointed out a pO2 of 103 mmHg, potassium 3.3 mEq/L, calcium 1.09 mmol/L and glucose 113 mg/dL. The blood routine tests revealed: white blood cell count 3.99 10^9/Liter, red blood cell count 6.41 10^12/Liter, hemoglobin 13.4 g/dL, hematocrit 40.1%, neutrophils 1.99 10^9/Liter, lymphocytes 39.9%, D-dimers 0.526 ug/mL, troponin T 7.22 ng/L, ferritin 192 ng/mL, procalcitonin 15 ug/L, creatine kinase-MB 27 U/L, lactic acid dehydrogenase (LDH) 481 U/L, fibrinogen 455 mg/dL, normal liver and renal function, normal prothrombin time. The electrocardiogram was normal. On 22th of April, the lab confirmed that the oropharyngeal swab test of SARS-CoV-2 by qualitative real-time reverse-transcriptase–polymerase-chain-reaction (RT-PCR) assay was positive. After seven days of symptomatic treatment and hydroxychloroquine therapy, the patient’s respiratory symptoms significantly improved. The dynamics of high-resolution CT of the chest revealed systematic a…
creator: Petru E. MUNTEAN, Cristina G. NECULCEA
source: Archives of the Balkan Medical Union
publisher: Balkan Medical Union
date: 2020
identifier: DOI: doi.org/10.31688/ABMU.2020.55.2.24
coverage: Medicine (General), Medicine