Radiological signs of a new coronavirus infection COVID-19

Abstract

Purpose . To evaluate the radiological patterns of a new COVID-19 coronavirus infection. Materials and methods . Review of literature sources. Results . COVID-19 causes the acute severe viral pneumonia. Radiological diagnostics of COVID-19 is very important, because CT can be the first study that shows the signs of viral lung lesion, and allows to assess the severity of the lesion and adverse prognostic signs of its further development. The initial CT pattern of COVID-19 is a pattern of infiltration of secondary pulmonary lobules on the type of «frosted glass» (a symptom of «dry leaf») with a subsequent decrease in the volume of lesions at favorable results, or their increase, accession of CT pattern of «cobblestone road» and the appearance in the area of «frosted glass» the alveolar infiltration in unfavorable course of disease. These symptoms are the precursors to the development of respiratory distress syndrome. At a later primary examination, the primary CT symptoms are the pattern of «cobblestone road» and areas of alveolar infiltration, which correlates with an unfavorable further course and outcome. There was noted that viral pneumonia in COVID-19 was characterized by the location of changes in the posterior subpleural and peribronchial areas. All authors confirmed that cavities, nodules, pleural and pericardial effusions, and lymphadenopathy were absent in COVID-19. In the course of observation, quantitative characteristics of the lesions with a score were proposed, the use of which can help in determining the prognosis. Also identified temporary staging of the process and the formation in some of patients the residual changes in the lungs the same as in influenza pneumonia H1N1 (2008–9гг, 2015–16.) and SARS SARS-CoV-2 (2003)which can start the process of development of progressive pulmonary fibrosis. There is a need for frequent CT studies (every 4 days) to enable timely assessment of rapid dynamics and changes in treatment tactics. The analysis of the results of the examination should be performed by at least 2 radiologists experienced in thoracic radiology, with the involvement of a third independent expert, in case of disagreement. All the authors confirmed the low information content of traditional radiography in assessing viral lung lesions. In some studies, chest radiographs were not performed, only CT as a more sensitive method for detecting early changes, similar to previous outbreaks of coronavirus. However, the role of traditional radiography was recognized as unquestionable when evaluating changes in reanimation department conditions. Conclusions . The accumulation of experience in clinical and radiological examination of COVID-19 patients allowed to determine the radiological semiotics of the process, which is important for determining the treatment tactics.