Objective: To identify and characterize the predominant tomographic pattern in the infection caused by the SARS-CoV-2 virus within the first 7 days of evolution. Material and methods: Qualitative, observational and cross-sectional study of patients older than 18 years with a positive result for COVID-19 confirmed by the RT-PCR test, within the first 7 days of symptomatic evolution, with chest CT on 25/March/2020 to 23/ May/2020. Study carried out at the Regional Hospital of High Specialty of the ISSSTE of Veracruz, Mexico. Database registered in Excel, statistical study carried out with the SPSS Statistics-23 program. Results: 150 patients were studied, 45.3%(68) were women and 54.7%(82) men. Presence of multiple lesions in 92%(138), single lesion 2.7%(4) and without alterations 5.3%(8). Bronchioalveolar infiltrate in 88% ( 132), ground glass opacities 83.3%(125), consolidations 59.3%(89), cobblestone pattern 4%(6) and pleural effusion 2.6%(4). On the fourth day of evolution, 54.5% of tomographic lesions were identified and 89.48% on the fifth day. Conclusion: The chest tomographic study carried out from the fourth day of evolution allows to integrate a better diagnostic evaluation in patients with COVID-19. The diversity of the lesions and the degree of affection allow the clinician to make diagnostic and therapeutic decisions.

Se presenta el caso clínico de una paciente de sexo femenino de 93 años con dolor abdominal generalizado posterior a la ingesta de alimentos con seis meses de evolución. Se realiza una tomografía computarizada, diagnosticando situs inversus ambiguo poliesplénico con isomerismo izquierdo. El situs inversus ambiguo es una anomalía congénita caracterizada por la posición opuesta de los órganos abdominales y por la presencia de levocardia, habiendo una subclasificación en poliesplénico (bazo multilobulado) o asplénico (sin bazo) e isomerismo izquierdo (pulmones trilobulados) o derecho (pulmones bilobulados). Los pacientes suelen ser asintomáticos y se diagnostican por la presencia de apendicitis, colecistitis o mediante exámenes ordinarios.