How important is radiology in diagnosing COVID-19 infection?
MMG: ‘Radiology is fundamental in this process. The radiologist's main contribution is to facilitate and expedite as much as possible the exploration, help design specific circuits and provide a fast and accurate report of the radiological findings that should indicate whether or not these are consistent with the COVID-19 coronavirus infection.’
These two X-ray images are from a 72-year-old woman who has a cough and respiratory distress from last year (left) and now. The yellow circle and ovoid indicate the typical subpleural peripheral opacities
HiE: What are the typical radiological findings?
MMG: ‘The findings that make us strongly suspect that we are dealing with a COVID-19 infection are the ground glass patterned areas, which, even in the initial stages, affect both lungs, in particular the lower lobes, and especially the posterior segments, with a fundamentally peripheral and subpleural distribution. These findings are present on chest CT in practically 50% of patients in the first two days; For this, in China, CT is being used as a screening or diagnostic method.
‘These lesions progress in the following days until they become more diffuse. If they associate with septal thickening, they will present with a crazy paving pattern. In general, they progress in extension and also towards the consolidation that is done concomitantly with the ground glass pattern, which can present a rounded morphology. It is very rare that it associates lymphadenopathy or capitation or pneumothorax, as the Middle East respiratory syndrome coronavirus (MERS-CoV) did.’
Consider utilizing portable radiography units in ambulatory care facilities when chest x-rays are “considered medically necessary.” Surfaces on such machines are easily cleaned, and their use helps keep radiography rooms open for other patients.
