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.

Filippo Barbiera – ASP Agrigento Presidio Ospedaliero di Sciacca (AG)

48-year-old female
MD with cough since February 29 and RT-PCR test positive.  Blood test: 
leukopenia.

Potential risk for SARS-CoV-2 exposure (one contact coming from “high-risk” area)

CT

Izzo Andrea, D’Aversa Lucia, Cerimoniale Giuseppe, Mazzella Giuseppe, Pergoli Pericle, Faiola Eugenio Leone, Di Pastena Francesca

U.O.C.  Diagnostica per immagini – Ospedale “Dono Svizzero” Formia DEA I livello– Asl Latina

58-year-old female
with dyspnea and fever for one week. Medical history: COPD and DCM and severe
hearth failure (EF: 25%), obesity. 

Chest film:

Diffuse
interstitial markings with alveolar consolidations in the upper lobes. Cardiomegaly.
No pleural effusion.

Since the chest
radiography findings were highly suspicious for interstitial pneumonia, the
radiologist asked for a nasal swab which confirmed a SARS-CoV-2 infection.

The following CT revealed the typical Covid-19 pneumonia features.

Izzo Andrea, D’Aversa Lucia, Cerimoniale Giuseppe, Mazzella Giuseppe, Pergoli Pericle, Faiola Eugenio Leone, Di Pastena Francesca

U.O.C.  Diagnostica per immagini – Ospedale “Dono Svizzero” Formia DEA I livello– Asl Latina

55- year-old female
patient with dyspnea for a few days; no fever. pO2:70%. Potential exposure to
the SARS-CoV-2. Medical history: asthma and DM.

Chest radiography:

Findings
consistent with interstitial pneumonia.

The RT-PCR test on nasopharyngeal swab turned positive and the patient was transferred to the referral center (Spallanzani Hospital in Rome).

Izzo Andrea, D’Aversa Lucia, Cerimoniale Giuseppe, Mazzella Giuseppe, Pergoli Pericle, Faiola Eugenio Leone, Di Pastena Francesca

U.O.C.  Diagnostica per immagini – Ospedale “Dono Svizzero” Formia DEA I livello– Asl Latina

71- year-old female
patient admitted to the ED with dyspnea, no fever. pO2: 97%, tachypnea.  Medical history: COPD, HTA, DM, chronic renal
failure, mitral valve replacement.  No
exposure to Covid-19 patients.

Chest radiography:

L’indagine RX dimostra un diffuso incremento della trama interstiziale peribroncovascolare con associati multipli addensamenti parenchimali bilateralmente. Versamento pleurico a destra con obliterazione del seno costofrenico di questo lato. 

The RT-PCR test
revealed SARS-CoV-2 infection.

CT

Multiple and large ground glass with reticulations with “crazy-paving” pattern associated with consolidations. Right pleural effusion.