COVID-19: case 14

UOC Radiologia ASST Bergamo Est Direttore Dr Gianluigi Patelli

50-year-old male outpatient presented for a chest radiography. He reported with sick cough asthenia and fever for two days, with progressive worsening of his clinical conditions.  pO2: 93%.

Chest radiography

After the chest film, the patient underwent CT for a better characterization of his pulmonary abnormalities which were suspicious for Covid-19 interstitial pneumonia.

CT

The patient was then admitted to the ED to activate the procedures for nasopharyngeal swab and hospitalization.




COVID-19: case 23

Izzo Andrea, D’Aversa Lucia, Cerimoniale Giuseppe, Mazzella Giuseppe, Pergoli Pericle, Faiola Eugenio Leone, Di Pastena Francesca

U.O.C.  Diagnostica per immagini – Ospedale “Dono Svizzero” Formia DEA I livello– Asl Latina

27-year-old male patient transferred from another hospital for suspected pneumonia. No prior medical history, no exposure to Covid-19 patients. pO2: 92%.

Chest radiography

Slight interstitial markings with subpleural consolidation in the right upper/medium lobe.

The RT-PCR test on nasopharyngeal swab turned positive.

CT

Multiple ground-glass opacities and alveolar consolidations with predominant subpleural distribution in the upper and lower lobes.




COVID-19: case 46

Alessandro Rosa – Giuliano Gagliardi 

DIAGNOSTICA PER IMMAGINI AORN MOSCATI AVELLINO  

61-years-old male, transferred from another hospital. Onset of symptoms (arthralgia, asthenia) on February 27, 2020. Dyspnea and fever (38.5°) since March 2. Venturi mask with reservoir of 15l e pO2 85%, reaching 98% after positioning Venturi at 60% and 15 l.

CT

Subpleural
consolidations in the lower lobes, especially in the apical segments and in the
posterior segment of the RUL and the apicoposterior segment of the LUL.  Ground-glass opacities predominantly in the
subpleural regions are seen in the spared segments of the upper lobes. No
mediastinal nodes.

RT-PCR positive for SARS-CoV-2.

Bedside chest radiography

Diffuse interstitial marking and band atelectasis.




COVID-19: case 20

G. Valeri, G. Neri, L. Cola°, A Rebonato °°

UOC Radiodiagnostica; ° UOC Anestesia e Rianimazione, Ospedale di Fermo, AV4 ASUR Marche; °° UOC Diagnostica per Immagini, AO Riuniti Marche Nord

75-year-old male
patient with asthenia, sick cough and fever for 3 days. No prior medical
history.

Blood test: C-RP
15, Procalcitonin: 8.9

RT-PCR on a nasopharyngeal swab positive for SARS-CoV-2.

CT

Multiple and predominantly subpleural “ground-glass” opacities with reticulation and consolidations, involving all lobes, especially the upper lobes.

CT 9 days after:

Regression of the pulmonary abnormalities.




COVID-19: case 47

Silvia Lucarini, Chiara Moroni, Antonella Masserelli, Edoardo Cavigli, Lina Bartolini, Alessandra Bindi, Silvia Pradella AOU Careggi, Firenze, Direttore Dr. Vittorio Miele.

61-years-old male
patient admitted to the ED for severe dyspnea, confusion on March 3.  Bedfast after a recent upper respiratory
infection. Medical history: DM type 2, HTA. Non-smoker.

Blood test: WBC
11.2; C-PR 301 (normal values < 5); LDH 738 (normal values 135-225);
Fibrinogen 798 (normal values 200-400); INR 1.4. ABG: PaO2 82; PCO2 32.

A CTA was performed for suspected pulmonary embolism:

Multiple aree di ground-glass estese diffusamente in entrambi i polmoni con inizali aspetti consolidativi nelle regioni basali ove si evidenzia risparmio subpleurico; coesiste moderata riduzione volumetrica di entrambi i polmoni.

Multiple and
diffuse ground-glass opacities involving both lungs, associated with
consolidations at the bases, those sparing the cortex. Lungs volume is also
reduced.

The patient was promptly intubated and a treatment with Lopinavir-Ritonavir and Cloroquine was also started.

Chest film after intubation (March 3):

Chest film on March 6:

comparing to the previous CRX, an improvement of the pulmonary involvement is seen.

On March 12, a chest radiography was required due an increase of the procalcitonin levels (1.96, normal values <0.5):

A new-onset
consolidation in the left base is noted, finding suspected for bacterial superimposed
infection.

Antibiotics are then introduced along with redemsivir.




COVID-19: case 45

Cristina Veirana, Alessandro Gastaldo

UOC Radiologia, Ospedale San Paolo, Savona, Direttore dott. Alessandro Gastaldo

79-years-old patient, with cough and fever since February 29; the patient was hospitalized for pneumonia on March 1. 

Medical history: DM, cardiopathy. Potential risk for SARS-CoV-2 exposure (travel by bus from Venice – high-risk area – on February 16).

Chest Radiography:
slight interstitial marking at the left base.

On March 3, a CT was performed for clinical worsening:

Bilateral interstitial
pneumonia.

The patient was intubated and transferred to the infectious disease department.

The patient died on March 4.




COVID-19: case 59

P.Nespoli, P. Moretto, D. Sardo, P. Hosseinollahi, A. De Pascale, G. Garofalo, A. Veltri

AOU San Luigi Gonzaga, Orbassano, Radiodiagnostica, Direttore: Prof. A. Veltri

30-year-old male
patient with general malaise and fever for 5 days. Cough and dyspnea for two
days. No prior medical history.

Chest Radiography,
March 16, 2020:

Bilateral pulmonary consolidations, predominantly in the right lung.




COVID-19: case 53

Michele Forte

UO di radiologia diagnostica ed interventistica, Ospedale “Madonna delle Grazie”, Matera 

78-year-old patient with fever and cough for 1 week. pO2: 84 %.

CT

Diffuse ground-glass opacities associated with reticulations involving all lobes, predominantly in the upper lobes and in the left lower lobe.




COVID-19: case 54

R. Campa, A. Leonardi, C. Valentini, R. Occhiato

Radiologia AOU Policlinico Umberto I – Sapienza Università di Roma, Dir. Prof. C. Catalano.

Patient presented
for cough and dyspnea for 5 days, not responding to antibiotics. Potential risk
for SARS-CoV-2: he traveled from Florence to Rome by train coming from a “high-risk
area” on February 24.

Medical history: HTA. At physical examination: crackles of the left base.

Chest radiography

Ill-defined consolidations with peripheral distribution, associated with increased interstitial marking. No pleural effusion.

CT

Ground-glass opacities with reticulations in a peripheral distribution. No pleural effusion neither mediastinal or hilar adenopathies. Findings consistent with Covid-19 pneumonia.




COVID-19: case 27

Izzo Andrea, D’Aversa Lucia, Cerimoniale Giuseppe, Mazzella Giuseppe, Pergoli Pericle, Faiola Eugenio Leone, Di Pastena Francesca

U.O.C.  Diagnostica per immagini – Ospedale “Dono Svizzero” Formia DEA I livello– Asl Latina

58-year-old female
with dyspnea and fever for one week. Medical history: COPD and DCM and severe
hearth failure (EF: 25%), obesity. 

Chest film:

Diffuse
interstitial markings with alveolar consolidations in the upper lobes. Cardiomegaly.
No pleural effusion.

Since the chest
radiography findings were highly suspicious for interstitial pneumonia, the
radiologist asked for a nasal swab which confirmed a SARS-CoV-2 infection.

The following CT revealed the typical Covid-19 pneumonia features.