Middle East Respiratory Syndrome Coronavirus: What Does a Radiologist Need to Know?

Abstract

An increased awareness of MERS-CoV and an understanding of the radiologic features of MERS-CoV can improve the early assessment and monitoring of this new infection. Radiologists can provide information based on chest radiographic and CT scores that can be helpful for patient management and predicting prognosis.

Middle East respiratory syndrome

“…77,78 Imaging A range of abnormal but non-specific chest x-ray findings are seen in patients with MERS. 91,92 These abnormal ities include unilateral or bilateral bronchovascular shadowing, interstitial infiltrates, reticular opacities, reticulonodular shadowing, nodules, pleural effusions, and patchy to confluent consolidation (appendix pp [18][19]. Lower lobes tend to be affected more than upper lobes early in the course of MERS and rapid opacification of lungs and progression to acute respiratory distress syndrome can occur.…”

Coronavirus (COVID-19) Outbreak: What the Department of Radiology Should Know

“…In 83% of patients with MERS coronavirus infection, initial radiography will show some degree of abnormality, with ground-glass opacities being the most common finding [14]. Likewise, CT will show bilateral and predominantly groundglass opacities, with a predilection to basilar and peripheral lung zones, but observation of isolated consolidation (20%) or pleural effusion (33%) is not uncommon in MERS [15].…”

MERS coronavirus outbreak: Implications for emerging viral infections

“…Bilateral pleural effusion has also been identified as an independent predictor of short-term mortality for community-acquired pneumonia but not SARS (Hasley et al, 1996;Wong et al, 2003). Similar to the radiographic findings, the more sensitive computed tomography (CT) scans also showed ground glass opacity (53% of patients), or consolidation (20% of patients), or both together (33% of patients), as well as pleural effusion (33%) and interlobular thickening (26%) within a week of infection (Das et al, 2015(Das et al, , 2016. As disease progressed, bronchial abnormalities and organizing pneumonia emerged on CT scans (Das et al, 2015(Das et al, , 2016.…”

“…For the first time, ultrastructural viral particles were shown in renal cells, as well in pneumocytes, pulmonary macrophages and macrophages infiltrating the skeletal muscles (Alsaad et al, 2018). A wide range of radiological features have been shown on chest X-rays of MERS-CoV infected patients including ground glass opacification, consolidation (either patchy or confluent), reticular opacities, nodular opacities and reticulo-nodular infiltrates Das et al, 2015Das et al, , 2016. Use of serial chest radiographs can be used to classify disease progression into 4 types ranging from type 1, in which initial radiographic deterioration is followed by improvement, all the way up to type 4, where there is progressive radiographic deterioration (Das et al, 2016).…”

“…A wide range of radiological features have been shown on chest X-rays of MERS-CoV infected patients including ground glass opacification, consolidation (either patchy or confluent), reticular opacities, nodular opacities and reticulo-nodular infiltrates Das et al, 2015Das et al, , 2016. Use of serial chest radiographs can be used to classify disease progression into 4 types ranging from type 1, in which initial radiographic deterioration is followed by improvement, all the way up to type 4, where there is progressive radiographic deterioration (Das et al, 2016). Importantly, in a study of 55 adult patients with acute MERS-CoV infection, chest radiographic score was shown to be an independent predictor of mortality, with mean chest radiographic score significantly higher in patients who died than in those who survived.…”