Three unsuspected CT diagnoses of COVID-19

Abstract

Purpose: Coronavirus disease 2019 (COVID-19) is caused by a novel strain of coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that has quickly spread around the globe. Health care facilities in the USA currently do not have an adequate supply of COVID-19 tests to meet the growing demand. Imaging findings for COVID-19 are non-specific but include pulmonary parenchymal ground-glass opacities in a predominantly basal and peripheral distribution.

Methods: Three patients were imaged for non-respiratory-related symptoms with a portion of the lungs in the imaged field.

Results: Each patient had suspicious imaging findings for COVID-19, prompting the interpreting radiologist to suggest testing for COVID-19. All 3 patients turned out to be infected with COVID-19, and one patient is the first reported case of the coincident presentation of COVID-19 and an intraparenchymal hemorrhage.

Conclusion: Using imaging characteristics of COVID-19 on abdominal or neck CT when a portion of the lungs is included, patients not initially suspected of COVID-19 infection can be quarantined earlier to limit exposure to others.

Keywords: COVID-19; Ground-glass opacities; Intraparenchymal hemorrhage.

Fig. 1

Axial images (a and b) from a contrast-enhanced CT of abdomen and pelvis through the lung bases show several ground-glass opacities bilaterally

Fig. 2

Axial image from a contrast-enhanced CT of abdomen and pelvis through the lung bases display round ground-glass opacities at the periphery

Fig. 3

Axial non-contrast head CT (a) shows a left basal ganglia hemorrhage. Axial (b) and coronal (c) reconstructed images from a CT angiogram of the head and neck through the upper lungs shows a nodule at the periphery of the left upper lobe