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Objective The objective of this study was to assess the initial results of chest computed tomography (CT) standardized diagnostic criteria proposed by the Radiological Society of North America in coronavirus disease 2019 (COVID-19) compared with reverse transcription–polymerase chain reaction (RT-PCR). Methods Seventy-one patients who underwent RT-PCR test for COVID-19 and chest CT within an interval of 4 days or less were included. Seventy-five CTs were reviewed and classified as typical, indeterminate, or atypical appearance or negative for pneumonia by 2 radiologists. With RT-PCR as reference standard, the performance of the CT diagnostic criteria in diagnosing COVID-19 was assessed. Results The prevalence of positive RT-PCR was 45.1%. It was obtained a sensitivity of 83% (95% confidence interval [CI], 78%–89%), a specificity of 97% (95% CI, 92%–99%), an accuracy of 91% (95% CI, 85%–96%), a positive predictive value of 97% (95% CI, 91%–99%), and a negative predictive value of 86% (95% CI, 80%–92%). The diagnostic performance was excellent, considering the area under the curve of 0.92 (95% CI, 0.84–0.99). Conclusions Chest CT standardized diagnostic criteria had high specificity and positive predictive value for the diagnosis of COVID-19 when presenting a typical appearance.

A 17-year-old man with normal blood pressure presented with acute bilateral blindness, and retro-orbital pain two days after treatment with tocilizumab (TCZ) for juvenile idiopathic arthritis. The diagnosis was posterior reversible encephalopathy syndrome (PRES), made after clinical examination and MRI (Figure). Tocilizumab was discontinued and the patient partially improved. To the best of our knowledge, there are no reports of this association (PRES and TCZ) in PubMed. This manuscript describes a new association between TCZ and PRES based on imaging findings, in which the patient presented with more severe imaging findings and did not have complete recovery of the symptoms 1,2,3 .

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