Andrea Nardi, Giovanni Carbognin

Radiologia – Ospedale IRCSS Sacro Cuore Don Calabria – Regione Veneto – Negrar (VR)

72-years-old
female patient presented to the ED on March 5 with fever, diarrhea and
dyspepsia for three days. She had contacts with a person affected with SARS COV
2. Physical examination: T 36.9°C, SpO292%.

Blood tests at the
hospitalization in the infectious disease department on March 7: WBC: 4.6;
lymphocytes: 0.7U/L; RCP: 141mg/l.

Chest radiography:
unremarkable

CT

Bilateral alveolar consolidations in the posterior regions of the inferior lobes. Supleural nodules in the anterior segments of the left upper lobe. Multiple and diffuse ground glass opacities in all lobes. No pleural effusion.

E Sardo, A Molinari, A Baletti, M Bazzocchi, G Bestagno, A D’amico, R Piccazzo, S Russo

Radiodiagnostica generale e senologica del Ponente – Ospedale di Sanremo – Direttore: Dr.ssa Stefania Russo

87-year-old male
patient with contact to a Covid-19 patient. He presented to the ED with
dyspnea, fever and cough. The nasal swab revealed SARS COV 2.  ABG: respiratory failure.

The patient died before he was admitted in the ICU.

CT

Bilateral ground-glass opacities associated with reticulations (“crazy-paving” pattern) in a subpleural distribution.

PR Lolli, A Molinari, D Cataldo, M Fasciglione, R Lai, S Russo

Radiodiagnostica generale e senologica del Ponente – Ospedale di Sanremo – Direttore: Dr.ssa Stefania Russo

76-year-old male
patient admitted to the ED with acute abdominal pain. Potential risk for
contacts with Covid-19 patients.

An abdominal CT was
performed showing bowel perforation requiring surgery; moreover, lungs abnormalities
were seen in the lower regions of the chest included in the examination.
Therefore, the radiologist also acquired a chest CT and activate the procedure
for the nasal swab.

The patient died after surgery. Covid-19 pneumonia was confirmed by RT-PCR.

CT

-Bilateral and diffuse ground-glass opacities.
-Free gas within the peritoneal cavity peritoneum consistent with bowel perforation and free fluid within the abdomen.

Gianluca Firullo, Francesca Ferrari, Mauro Martinetti, Valeria De Matteis.

ASL Verbano-Cusio-Ossola, direttore UOC Attilio Guazzoni.

63-year-old with no risk for Covid-19 exposure. The patient presented to the ED with syncope. Head CT and EKG were unremarkable. D-dimer was high, so a CTA for pulmonary embolism was performed which revealed scattered ground-glass opacities with reticulations and subpleural band consolidations in the posterior regions.

The patient developed an ARDS as well as leukopenia and an increase in transaminases. CPR slightly increased.

The following HRCT showed a progression of the interstitial pneumonia with diffuse “crazy paving” pattern.

RT-PCR was
positive for SARC-CoV-2 ant the patient was transferred to a referral center.

A dedicated sanitization was performed, requiring a 12-hours inactivity of the ED and the medicine department where the patient was hospitalized. Isolation was enforced to the physicians and health-workers involved in the patient care.

G.Patelli, F.Besana, S. Paganoni* , F.Codazzi* , A.Tedeschi**

*UOC Radiologia ASST Bergamo Est; **UOC Medicina ASST Bergamo Est

47-year-old male
patient with asthenia, arthralgia, headache, sick cough and fever 39°C since
March 1 presented to the ED on March 4.  No
prior medical history. pO2: 95%.

Chest radiography
March 4: unremarkable.

Due to the discrepancy between clinical and radiological findings, a CT is performed.

Ill-defined
consolidations suspected for early-stage of interstitial pneumonia.

In consideration
of the CT findings, a nasal swab was obtained resulting positive for SARS-CoV-2.

The patient was
then hospitalized on March 4 and treated with Ceftriaxone 2gr /day ed
Azitromicina 500 mg/day. On March 6, Kaletra 800+100 mg /day e Plaquenil 400
mg/day were introduced with improvement of the clinical conditions since March
9

On March 10 both chest film and CT are performed.

Chest radiography:

Alveolar and interstitial consolidations.

CT

Development of a dense consolidative pattern and interstitial bands, consistent with good evolution of the disease.

Dott. Foà Riccardo Alessandro, Dott. Spinazzola Angelo.

U.O di Radiologia ASST CREMA – Ospedale Maggiore di Crema

55-year-old male
patient with onset of cough and fever on February 24, in quarantine due to a
known contact with a Covid-19 patient. No previous medical history.  

The patient developed respiratory failure and underwent CT, performed on March 1:

which revealed multiple ground-glass opacities.

Clinical conditions were stables and a CT was performed on March 6:

Some the previous ground-glass opacities are reduced in both density and dimensions (subpleural and paravertebral on LUL), while other increased and new-onset ground-glass opacities are also detected (anterior segment of the LUL, lateral segment of the ML, apical segments of both RLL and LLL).  No pleural effusion no mediastinal adenopathies.

R. Bonacini, G. Besutti, P. Pattacini
Radiologia IRCCS Reggio Emilia; Direttore Pierpaolo Pattacini

43-year-old male with fever and asthenia for 7 days. Blood test: negative (including C-PR, procalcitonin and CBC). No previous medical history.

Chest radiography:

Blurred, ill-defined consolidation in the right lower lobe.

CT

Large ground-glass opacity with reticulations and small peripheral consolidations in the RLL; scattered GGOs in the LUL.

The RT-PCR test on nasal swab turned positive.

R. Bonacini, G. Besutti, P. Pattacini
Radiologia IRCCS Reggio Emilia; Direttore Pierpaolo Pattacini

63-year-old male with fever, pharyngalgia asthenia and diarrhea for 5 days. Blood test:  C-PR 16.27 mg/dl, procalcitonin and CBC unremarkable. Medical history: Obstructive sleep apnea syndrome.

Chest radiography:

Multiple and bilateral consolidations.

CT

Multiple and bilateral ground-glass opacities with consolidations.

The RT-PCR test on nasal swab turned positive.

R. Bonacini, G. Besutti, P. Pattacini
Radiologia IRCCS Reggio Emilia; Direttore Pierpaolo Pattacini

64-year-old male
with dyspnea, cough and fever for 3 days. Blood test:  C-PR 13.44 mg/dl, procalcitonin and CBC
unremarkable. Medical history: DM, HTA.

Chest radiography:

Multiple and bilateral consolidations.

CT

Bilateral scatterd
ground-glass opacities with predominant subpleural distribution.

The RT-PCR test on nasal swab turned positive.

R. Bonacini, G. Besutti, P. Pattacini
Radiologia IRCCS Reggio Emilia; Direttore Pierpaolo Pattacini

68-year-old male
with fever, dyspnea and diarrhea for 7 days. Blood test:  leukocytosis, increased C-PR, procalcitonin in
the range. Medical history: chronic lymphocytic leukemia under follow-up,
dyslipidemia and HTA.

Chest radiography:

Multiple and bilateral band consolidations. No pleural effusion.

CT

Multiple and
bilateral scatterd ground-glass opacities with predominant subpleural
distribution associated with reticulations and alveolar consolidations.

12h after, the
patient went into a respiratory distress requiring the hospitalization in ICU.

The RT-PCR test on nasal swab turned positive.