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Vol. 63. Issue 2.
Pages 180-192 (March - April 2021)
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Vol. 63. Issue 2.
Pages 180-192 (March - April 2021)
Serie: Radiology and COVID-19
DOI: 10.1016/j.rxeng.2020.11.003
When pneumonia is not COVID-19
Cuando la neumonía no es COVID-19
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J.J. Arenas-Jiméneza,
Corresponding author
j.arenasjimenez@gmail.com

Corresponding author.
, J.M. Plasencia-Martínezb, E. García-Garrigósa
a Servicio de Radiodiagnóstico, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
b Área de Urgencias y de Imagen Cardiaca, Servicio de Radiodiagnóstico, Hospital Universitario Morales Meseguer, Murcia, Spain
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Table 1. Relative frequency of the different image characteristics of computed tomography in acute SARS-CoV-2 infection.
Table 2. Some diseases that may call for a differential diagnosis with COVID-19 of multiple pulmonary opacities in patients with acute/subacute dyspnea.
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Additional material (1)
Abstract

During the COVID-19 epidemic, the prevalence of the disease means that practically any lung opacity on an X-ray could represent pneumonia due to infection with SARS-CoV-2. Nevertheless, atypical radiologic findings add weight to negative microbiological or serological tests. Likewise, outside the epidemic wave and with the return of other respiratory diseases, radiologists can play an important role in decision making about diagnoses, treatment, or preventive measures (isolation), provided they know the key findings for entities that can simulate COVID-19 pneumonia. Unifocal opacities or opacities located in upper lung fields and predominant airway involvement, in addition to other key radiologic and clinical findings detailed in this paper, make it necessary to widen the spectrum of possible diagnoses.

Keywords:
COVID-19
Computed tomography
X-rays
Radiography
Diagnostic imaging
Resumen

La prevalencia en fase epidémica de la COVID-19 hace que prácticamente cualquier opacidad pulmonar en la radiografía de tórax pueda ser una neumonía por SARS-CoV-2. Sin embargo, hallazgos radiológicos atípicos aumentarán la credibilidad de un resultado microbiológico o serológico negativo. Asimismo, fuera de la ola epidémica y con el retorno de otras entidades respiratorias, el radiólogo puede tener gran relevancia en la toma de decisiones diagnósticas, terapéuticas o preventivas (aislamiento) si conoce las claves diagnósticas de las entidades simuladoras de neumonía COVID-19. La distribución unifocal o en campos pulmonares superiores de las opacidades y la afectación predominante de vía aérea, entre otras claves radiológicas y clínicas detalladas en este capítulo, implican necesariamente ampliar el abanico de posibilidades diagnósticas.

Palabras clave:
COVID-19
Computed tomography
X ray
Radiography
Diagnostic imaging

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