Diagnóstico radiológico del paciente con COVID-19

When pneumonia is not COVID-19

“…Signs on chest X-ray in COVID-19 faithfully follow the patterns seen on CT, 1 , 12 , 13 with a bilateral and peripheral distribution as well as a tendency towards a basal predominance (the most characteristic), in the form of frank consolidation, fainter opacities (which can be labelled “ground-glass” opacities, as in CT semiology) or more linear or reticular lesions. 1 , 12 , 14 , 15 , 16 However, it must always be borne in mind that, in the epidemic phase, almost any pulmonary opacity could correspond to SARS-CoV-2 pneumonia.…”

“… 9 With the exception of the most characteristic patterns of the disease, reported in this same journal by Martínez et al, 1 outside the epidemic phase, the radiological presentation of COVID-19 can be completely non-specific and indistinguishable from non-infectious and infectious diseases of another aetiology. Negative PCR test results in a significant percentage of patients with COVID-19 1 , 10 mean that imaging tests, along with epidemiological, clinical and laboratory data, can play an important role in making decisions about isolation and treatment. To help manage the disease, radiologists must be alert to signs that suggest an infectious nature yet mandate consideration of an alternative diagnosis to COVID-19 as well as a bacterial co-infection or superinfection.…”

“…Solitary pulmonary lesions (nodules, masses, cavitated lesions, etc. ), pleural effusion, hilar lesions and mediastinal lesions as dominant findings are rare in COVID-19, 1 and lie beyond the scope of this review.…”

“…To help manage the disease, radiologists must be alert to signs that suggest an infectious nature yet mandate consideration of an alternative diagnosis to COVID-19 as well as a bacterial co-infection or superinfection. 1 , 11 To do this, evaluation of imaging in suspected SARS-CoV-2 pneumonia must be done with two considerations: the findings themselves and their distribution. Their relative frequency on CT is reflected in Table 1 .…”

“…As has been discussed in this journal, 1 , 2 during the epidemic phase of COVID-19, numerous studies have given a key role to imaging techniques in the initial diagnostic management of the disease, be they chest X-ray as a first-line technique to confirm an initial diagnosis of pneumonia, or computed tomography (CT) as a second step, considered a “definitive” diagnostic test due to its high sensitivity and specificity. However, the characteristics of the disease mean that, at some hospitals, COVID-19 has completely edged out most respiratory diseases and other medical emergencies.…”