TY - JOUR
T1 - 2019-novel Coronavirus severe adult respiratory distress syndrome in two cases in Italy
T2 - An uncommon radiological presentation
AU - Albarello, Fabrizio
AU - Pianura, Elisa
AU - Di Stefano, Federica
AU - Cristofaro, Massimo
AU - Petrone, Ada
AU - Marchioni, Luisa
AU - Schininà, Vincenzo
AU - Nicastri, Emanuele
AU - Petrosillo, Nicola
AU - Ippolito, Giuseppe
AU - COVID 19 INMI Study Group
AU - Agrati, Chiara
AU - Amendola, Alessandra
AU - Antonini, Mario
AU - Barbaro, Raffaella
AU - Bartolini, Barbara
AU - Bevilacqua, Nazario
AU - Bordi, Licia
AU - Bordoni, Veronica
AU - Capobianchi, Maria Rosaria
AU - Caravella, Ilaria
AU - Carletti, Fabrizio
AU - Castilletti, Concetta
AU - Chiappini, Roberta
AU - Colavita, Francesca
AU - Corpolongo, Angela
AU - Curiale, Salvatore
AU - D'Abramo, Alessandra
AU - Dantimi, Cristina
AU - Angelis, Alessia De
AU - Lorenzo, Rachele Di
AU - Di Stefano, Federica
AU - Ferraro, Federica
AU - Frustaci, Andrea
AU - Garotto, Gabriele
AU - Giancola, Maria Letizia
AU - Giansante, Filippo
AU - Giombini, Emanuela
AU - Lalle, Eleonora
AU - Lanini, Simone
AU - Lapa, Daniele
AU - Lepore, Luciana
AU - Marani, Alessandra
AU - Mariano, Andrea
AU - Maritti, Micaela
AU - Matusali, Giulia
AU - Meschi, Silvia
AU - Murachelli, Silvia
AU - Petrecchia, Antonella
AU - Pittalis, Silvia
AU - Puro, Vincenzo
AU - Rueca, Martina
AU - Sacchi, Alessandra
AU - Scognamiglio, Paola
AU - Scorzolini, Laura
AU - Stazi, Giulia
AU - Vairo, Francesco
AU - Valli, Maria Beatrice
PY - 2020/4
Y1 - 2020/4
N2 - Introduction: Several recent case reports have described common early chest imaging findings of lung pathology caused by 2019 novel Coronavirus (SARS-COV2) which appear to be similar to those seen previously in SARS-CoV and MERS-CoV infected patients. Objective: We present some remarkable imaging findings of the first two patients identified in Italy with COVID-19 infection travelling from Wuhan, China. The follow-up with chest X-Rays and CT scans was also included, showing a progressive adult respiratory distress syndrome (ARDS). Results: Moderate to severe progression of the lung infiltrates, with increasing percentage of high-density infiltrates sustained by a bilateral and multi-segmental extension of lung opacities, were seen. During the follow-up, apart from pleural effusions, a tubular and enlarged appearance of pulmonary vessels with a sudden caliber reduction was seen, mainly found in the dichotomic tracts, where the center of a new insurgent pulmonary lesion was seen. It could be an early alert radiological sign to predict initial lung deterioration. Another uncommon element was the presence of mediastinal lymphadenopathy with short-axis oval nodes. Conclusions: Although only two patients have been studied, these findings are consistent with the radiological pattern described in literature. Finally, the pulmonary vessels enlargement in areas where new lung infiltrates develop in the follow-up CT scan, could describe an early predictor radiological sign of lung impairment.
AB - Introduction: Several recent case reports have described common early chest imaging findings of lung pathology caused by 2019 novel Coronavirus (SARS-COV2) which appear to be similar to those seen previously in SARS-CoV and MERS-CoV infected patients. Objective: We present some remarkable imaging findings of the first two patients identified in Italy with COVID-19 infection travelling from Wuhan, China. The follow-up with chest X-Rays and CT scans was also included, showing a progressive adult respiratory distress syndrome (ARDS). Results: Moderate to severe progression of the lung infiltrates, with increasing percentage of high-density infiltrates sustained by a bilateral and multi-segmental extension of lung opacities, were seen. During the follow-up, apart from pleural effusions, a tubular and enlarged appearance of pulmonary vessels with a sudden caliber reduction was seen, mainly found in the dichotomic tracts, where the center of a new insurgent pulmonary lesion was seen. It could be an early alert radiological sign to predict initial lung deterioration. Another uncommon element was the presence of mediastinal lymphadenopathy with short-axis oval nodes. Conclusions: Although only two patients have been studied, these findings are consistent with the radiological pattern described in literature. Finally, the pulmonary vessels enlargement in areas where new lung infiltrates develop in the follow-up CT scan, could describe an early predictor radiological sign of lung impairment.
KW - COVID-19
KW - Crazy-paving
KW - CT-scan
KW - Enlarged pulmonary vessels
KW - Ground glass opacities
KW - SARS-COV2
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U2 - 10.1016/j.ijid.2020.02.043
DO - 10.1016/j.ijid.2020.02.043
M3 - Article
C2 - 32112966
AN - SCOPUS:85081314502
VL - 93
SP - 192
EP - 197
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
SN - 1201-9712
ER -