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World J Clin Cases. Aug 6, 2020; 8(15): 3177-3187
Published online Aug 6, 2020. doi: 10.12998/wjcc.v8.i15.3177
Typical and atypical COVID-19 computed tomography findings
Damiano Caruso, Tiziano Polidori, Gisella Guido, Matteo Nicolai, Benedetta Bracci, Antonio Cremona, Marta Zerunian, Michela Polici, Francesco Pucciarelli, Carlotta Rucci, Chiara De Dominicis, Marco Di Girolamo, Giuseppe Argento, Daniela Sergi, Andrea Laghi
Damiano Caruso, Tiziano Polidori, Gisella Guido, Matteo Nicolai, Benedetta Bracci, Antonio Cremona, Marta Zerunian, Michela Polici, Francesco Pucciarelli, Carlotta Rucci, Chiara De Dominicis, Marco Di Girolamo, Giuseppe Argento, Daniela Sergi, Andrea Laghi, Department of Surgical and Medical Sciences and Translational Medicine, “Sapienza”-University of Rome, Sant'Andrea University Hospital, AOU Sant’Andrea, Rome 00189, Italy
Author contributions: Caruso D, Polidori T, Laghi A concepted and designed the research; Polidori T, Guido G, Nicolai M, Bracci B, Zerunian M, Polici M, Pucciarelli F, Rucci C performed the research, the acquisition of images and the literature review; Caruso D, Polidori T, Guido G, Nicolai M, Bracci B, Zerunian M, Polici M, Pucciarelli F, Rucci C, Cremona A, De Dominicis C, Di Girolamo M, Sergi D, Argento G contributed drafting the article or revising it critically for important intellectual content; Laghi A has provided the editing and the final approval of the version submitted to the Journal.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Andrea Laghi, MD, Doctor, Full Professor, Department of Surgical and Medical Sciences and Translational Medicine, “Sapienza”-University of Rome, Sant'Andrea University Hospital, AOU Sant’Andrea, Via di Grottarossa, 1035-1039, Rome 00189, Italy. andrea.laghi@uniroma1.it
Received: April 26, 2020
Peer-review started: April 26, 2020
First decision: July 3, 2020
Revised: July 10, 2020
Accepted: July 23, 2020
Article in press: July 23, 2020
Published online: August 6, 2020
Abstract

In December 2019 a novel coronavirus, named severe acute respiratory syndrome coronavirus 2 was identified and the disease associated was named coronavirus disease 2019 (COVID-19). Fever, cough, myalgia, fatigue associated to dyspnea represent most common clinical symptoms of the disease. The reference standard for diagnosis of severe acute respiratory syndrome coronavirus 2 infection is real time reverse-transcription polymerase chain reaction test applied on respiratory tract specimens. Despite of lower specificity, chest computed tomography (CT), as reported in manifold scientific studies, showed high sensitivity, therefore it may help in the early detection, management and follow-up of COVID-19 pneumonia. Patients affected by COVID-19 pneumonia usually showed on chest CT some typical features, such as: Bilateral ground glass opacities characterized by multilobe involvement with posterior and peripheral distribution; parenchymal consolidations with or without air bronchogram; interlobular septal thickening; crazy paving pattern, represented by interlobular and intralobular septal thickening surrounded by ground-glass opacities; subsegmental pulmonary vessels enlargement (> 3 mm). Halo sign, reversed halo sign, cavitation and pleural or pericardial effusion represent some of atypical findings of COVID-19 pneumonia. On the other hand lymphadenopathy’s and bronchiectasis’ frequency is unclear, indeed conflicting data emerged in literature. Radiologists play a key role in recognition of high suspicious findings of COVID-19 on chest CT, both typical and atypical ones. Thus, the aim of this review is to illustrate typical and atypical CT findings of COVID-19.

Keywords: SARS-CoV-2, COVID-19, Chest computed tomography, Interstitial pneumonia, Ground-glass opacities

Core tip: This review makes an effort to summarize typical and atypical chest computed tomography features in coronavirus disease 2019 (COVID-19) pneumonia associated to the novel coronavirus, severe acute respiratory syndrome coronavirus 19. The content of the article will prove to be helpful for readers to recognize the high suspicious chest computed tomography findings in COVID-19 pneumonia.