SARS-CoV-2 presentation, with atypical chest CT findings and what we have learned being on the front lines

Abstract

COVID 19 is a pandemic that has had a catastrophic impact. The healthcare infrastructure in most countries has been seriously tested, with the resolve of healthcare workers at truly heroic measures. The disease was first described in the Hubei region of China, but since has spread to 196 countries. Diagnosis has been the keystone of management, being as there does not exist a viable treatment regimen, medication or vaccine. We present a 51 year old female who was overcome by significant shortness of breath. Her laboratory testing and diagnostic imaging were not classically indicative of COVID 19. Her eventual confirmatory test, via RT-PCR was positive. She was managed with supportive care. COVID 19 patients classically present with fever, cough and increased fatigue. Laboratory findings predominantly include leukopenia, elevated lactate dehydrogenase (LDH), however these are not pathognomonic. The real time reverse transcriptase polymerase chain reaction, RT-PCR, test is advocated as the confirmatory test in presumptive positive patients. Diagnostic imaging, in particular CT Chest, has been important in establishing diagnoses, revealing ground glass opacities as characteristic findings in COVID 19 positive patients. Until a cure and/or vaccine are developed, the clinician’s index of suspicion along with diagnostic tests remain the only viable defense to prevent this pandemic from further spread and catastrophe.