Clinical features and radiological manifestations of COVID-19 disease

Abstract

Coronavirus disease 2019 (COVID-19) was discovered after unusual cases of severe pneumonia emerged in December 2019 in Wuhan Province (China). Coronavirus is a family of single-stranded RNA viruses. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is transmitted from person to person. Although asymptomatic individuals can transmit the virus, symptomatic patients are more contagious. The incubation period ranges from 3-7 d and symptoms are mainly respiratory, including pneumonia or pulmonary embolism in severe cases. Elevated serum levels of interleukins (IL)-2, IL-6, IL-7 indicate the presence of cytokine release syndrome, which is associated with disease severity. The disease has three main phases: Viral infection, pulmonary involvement, and hyperinflammation. To date, no treatment has proved to be safe or effective. Chest X-ray and computed tomography (CT) are the primary imaging tests for diagnosis of SARS-CoV-2 pneumonia, follow-up, and detection of complications. The main radiological findings are ground-glass opacification and areas of consolidation. The long-term clinical course is unknown, although some patients may develop pulmonary fibrosis. Positron emission tomography-computed tomography (PET-CT) is useful to assess pulmonary involvement, to define the affected areas, and to assess treatment response. The pathophysiology and clinical course of COVID-19 infection remain poorly understood. However, patterns detected on CT and PET-CT may help to diagnose and guide treatment. In this mini review, we analyze the clinical manifestations and radiological findings of COVID-19 infection.

Keywords: COVID-19; Coronavirus; Natural history; Clinical features; Pathogenesis; Radiology images

Core Tip: Coronavirus is a family of single-stranded RNA viruses transmitted from person to person. Asymptomatic individuals can transmit the virus, although symptomatic patients are more contagious. The incubation period is 3-7 d. Symptoms are mainly respiratory, including pneumonia or pulmonary embolism in severe cases. Blood tests typically show elevated levels of interleukins, associated with disease severity. The disease has three phases: Viral, pulmonary, and hyperinflammatory. To date, no treatment has proved safe or effective. Chest X-ray and computed tomography are the main imaging tests, used to diagnose pneumonia, for follow-up, and to detect complications. The most important radiological findings are ground-glass opacities and areas of consolidation. Some patients may develop pulmonary fibrosis. In patients with pulmonary involvement, positron emission tomography-computed tomography is useful to define the affected areas and to evaluate treatment response.