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Review
. 2023 May 26;13(11):1856.
doi: 10.3390/diagnostics13111856.

Role of Imaging in the Management of Patients with SARS-CoV-2 Lung Involvement Admitted to the Emergency Department: A Systematic Review

Cesare Maino  1 , Paolo Niccolò Franco  1 , Cammillo Talei Franzesi  1 , Teresa Giandola  1 , Maria Ragusi  1 , Rocco Corso  1 , Davide Ippolito  1   2
Affiliations
Review

Role of Imaging in the Management of Patients with SARS-CoV-2 Lung Involvement Admitted to the Emergency Department: A Systematic Review

Cesare Maino et al. Diagnostics (Basel). .

Abstract

During the waves of the coronavirus disease (COVID-19) pandemic, emergency departments were overflowing with patients suffering with suspected medical or surgical issues. In these settings, healthcare staff should be able to deal with different medical and surgical scenarios while protecting themselves against the risk of contamination. Various strategies were used to overcome the most critical issues and guarantee quick and efficient diagnostic and therapeutic charts. The use of saliva and nasopharyngeal swab Nucleic Acid Amplification Tests (NAAT) in the diagnosis of COVID-19 was one of the most adopted worldwide. However, NAAT results were slow to report and could sometimes create significant delays in patient management, especially during pandemic peaks. On these bases, radiology has played and continues to play an essential role in detecting COVID-19 patients and solving differential diagnosis between different medical conditions. This systematic review aims to summarize the role of radiology in the management of COVID-19 patients admitted to emergency departments by using chest X-rays (CXR), computed tomography (CT), lung ultrasounds (LUS), and artificial intelligence (AI).

Keywords: COVID-19; SARS-CoV-2; X-ray computed; artificial intelligence; coronavirus; infections; radiography; tomography; ultrasonography.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flowchart of the study.
Figure 2
Figure 2
Comparison between CXR and CT findings in a 62-year-old woman with SARS-CoV-2-related pneumonia. (A) Anteroposterior chest X-ray was reported negative for lesions of SARS-CoV-2-pneumonia. The subsequent CT in the axial (B) and coronal (C) planes set with the parenchymal window width, however, showed multiple, bilateral, slight GGOs, especially in the subpleural areas.
Figure 3
Figure 3
Comparison between chest X-ray and CT findings suggestive of SARS-CoV-2-related pneumonia in a 37-year-old man. (A) Chest X-ray shows the presence of multiple confluent mixed alveolar and linear opacities. CT images in the axial (B), and in the coronal plane (C) with window width and level for the evaluation of lung parenchyma allows to correctly identify the presence of the confluent ground-glass opacities, consolidations, and the additional finding of emphysema associated with bronchiectasis in the right upper lobe and both lower lobes.
Figure 4
Figure 4
Discordant imaging findings between chest X-ray and CT in a patient with SARS-CoV-2-related pneumonia. Lesions suggestive for SARS-CoV-2-pneumonia were not evident on anteroposterior CXR (A). On CT [(B) in the axial and (C) coronal planes], however, multiple reticulations and GGOs are found in the subpleural areas of the lungs bilaterally.
Figure 5
Figure 5
Management flow-chart of patients during ED admittance.
See this image and copyright information in PMC

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