Role of Imaging in Diagnosis and Management of COVID-19: A Multiorgan Multimodality Imaging Review.

Vinithra Varadarajan,Joao A. C. Lima,Bharath Ambale Venkatesh,Mahsima Shabani

doi:10.3389/fmed.2021.765975

Abstract

In this pandemic of Coronavirus disease 2019 (COVID-19), a vast proportion of healthcare resources, including imaging tools, have been dedicated to the management of affected patients; yet, the frequent reports of unknown presentations and complications of disease over time have been changing the usual standard of care and resource allocation in health centers. As of now, we have witnessed multisystemic symptoms requiring the collaboration of different clinical teams in COVID-19 patients' care. Compared to previous viral pandemics, imaging modalities are now playing an essential role in the diagnosis and management of patients. This widespread utility of imaging modalities calls for a deeper understanding of potential radiologic findings in this disease and identifying the most compatible imaging protocol with safety precautions. Although initially used for respiratory tract evaluation, imaging modalities have also been used for cardiovascular, neurologic, and gastrointestinal evaluation of patients with COVID-19. In this narrative review article, we provide multimodality and multisystemic review of imaging techniques and features that can aid in the diagnosis and management of COVID-19 patients.

Highlights

Coronavirus disease 2019 (COVID-19), caused by a novel enveloped single-stranded RNA virus, SARS-CoV-2, has emerged as a pandemic leading to a global public health crisis of the unprecedented magnitude of mortality and morbidity [1, 2]
We present the following article in accordance with a focus on diagnostic imaging implementation in North America
Studies have reported incidental COVID-19 findings in the lung bases observed in the non-pulmonary imaging of patients with non-COVID indications, including acute abdomen or preoperative scans [85, 86]

Summary

Introduction

Coronavirus disease 2019 (COVID-19), caused by a novel enveloped single-stranded RNA virus, SARS-CoV-2, has emerged as a pandemic leading to a global public health crisis of the unprecedented magnitude of mortality and morbidity [1, 2]. According to WHO guidelines, COVID-19 patients were divided into mild, moderate, severe, and critical stages based on symptoms, clinical signs, laboratory results, and imaging [5]. The clinical spectrum of COVID-19 ranges from asymptomatic carriers who can transmit the virus to mild clinical upper respiratory infection, which can progress to an acute respiratory distress syndrome (ARDS) in critically ill patients [6]. The most common symptoms in hospitalized patients were fever, dry cough, shortness of breath, nausea/vomiting, and diarrhea. Anosmia, dysgeusia, and gastrointestinal symptoms were reported among hospitalized patients [7]. About one-quarter of hospitalized patients require intensive care treatment, most commonly due to hypoxemic respiratory failure [8]. More than half of the ICU patients require mechanical ventilation.

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