2019-novel Coronavirus severe adult respiratory distress syndrome in two cases in Italy: An uncommon radiological presentation

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Date
2020-04
Author
Albarello, Fabrizio
Pianura, Elisa
Di Stefano, Federica
Cristofaro, Massimo
Petrone, Ada
Marchioni, Luisa
Palazzolo, Claudia
Schininà, Vincenzo
Nicastri, Emanuele
Petrosillo, Nicola
Campioni, Paolo
Zumla, Alimuddin
Eskild, Petersen
Ippolito, Giuseppe
Abbonizio, Maria Alessandra
Agrati, Chiara
Amadei, Gioia
Amendola, Alessandra
Antonini, Mario
Barbaro, Raffaella
Bartolini, Barbara
Benigni, Martina
Bevilacqua, Nazario
Bordi, Licia
Bordoni, Veronica
Branca, Marta
Capobianchi, Maria Rosaria
Caporale, Cinzia
Caravella, Ilaria
Carletti, Fabrizio
Castilletti, Concetta
Chiappini, Roberta
Ciaralli, Carmine
Colavita, Francesca
Corpolongo, Angela
Curiale, Salvatore
D'Abramo, Alessandra
Dantimi, Cristina
Angelis, Alessia De
Angelis, Giada De
Lorenzo, Rachele Di
Stefano, Federica Di
Ferraro, Federica
Fiorentini, Lorena
Frustaci, Andrea
Gallì, Paola
Garotto, Gabriele
Giancola, Maria Letizia
Giansante, Filippo
Giombini, Emanuela
Greci, Maria Cristina
Lalle, Eleonora
Lanini, Simone
Lapa, Daniele
Lepore, Luciana
Lucia, Andrea
Lufrani, Franco
Macchione, Manuela
Marani, Alessandra
Mariano, Andrea
Marini, Maria Cristina
Maritti, Micaela
Matusali, Giulia
Meschi, Silvia
Montaldo, Francesco Messina Chiara
Murachelli, Silvia
Noto, Roberto
Pallini, Emanuele
Passeri, Virgilio
Pelliccioni, Federico
Petrecchia, Antonella
Pisciotta, Maria
Pittalis, Silvia
Proietti, Costanza
Puro, Vincenzo
Rinonapoli, Gabriele
Rueca, Martina
Sacchi, Alessandra
Sanasi, Francesco
Santagata, Carmen
Scarcia, Silvana
Scognamiglio, Paola
Scorzolini, Laura
Stazi, Giulia
Vaia, Francesco
Vairo, Francesco
Valli, Maria Beatrice
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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.
URI
http://hdl.handle.net/20.500.12010/11041
Link to resource
https://www.sciencedirect.com/science/article/pii/S1201971220301016
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