Radiographic pulmonary description of bilateral multifocal patchy with ground-glass opacifications needs careful evaluation in the Era of SARS-CoV-2

Abstract

In the COVID-19 Era, multilobe ground-glass opacities (GGOs) and septal thickening on chest Computed Tomography (CT) have been recognized as a radiological finding highly suggestive for SARS-CoV-2 pneumonia. However, these findings can be misleading. Here, we report about an 81-year-old woman, evaluated in the Emergency Room (ER) for a traumatic hip fracture, who, despite negative molecular testing on the nasopharyngeal sample for SARS-CoV-2, was admitted to a COVID-Unit because of flu-like symptoms with GGOs and interlobular septal thickening on the chest CT. During the hospital stay, focusing on the patient’s medical history, the interstitial lung disease was defined to be a chronic complication of long-term use of Amiodarone and rheumatoid arthritis. Therefore, especially during SARS global pandemic, CT pathological findings suggestive for interstitial pneumopathy should be critically analyzed considering patient history. They can reflect, in fact, other pathological conditions different from SARS-CoV-2 infection as other viral and non-viral infections or chronic inflammatory diseases.