Miscellaneous
Contributor: Don Stader, MD Educational Pearls: COVID-19 commonly appears as a bilateral patchy infiltrate on chest radiograph, but this is a non-specific finding Sensitivities range from 17-70% for COVID-19 Many other viral pneumonias such as RSV and influenza can have similar findings Point-of-care ultrasound (POCUS) demonstrates B-lines, water-fall sign, or hepatization of the lung, but these are also non-specific Computerized tomography (CT) appears to be one of the more sensitive tests for detecting COVID-19, demonstrating ground-glass opacities - often before or without the patient having symptoms However, routine use of CT for diagnosis COVID-19 is strongly discouraged by many medical societies and the CDC Imaging may not be necessary in most patients presenting with suspected COVID-19 for multiple reasons: Diagnosis is often clinical suspicion, with or without confirmatory PCR testing (if available) Imaging does little to change the management in the majority of patients with COVID-19 Obtaining imaging exposes additional healthcare workers Cleaning protocols for units (especially CT) can be extensive and require significant downtime of the machine, thereby leading to delays in care References Farkas, Josh. “COVID-19.” EMCrit Project, 21 Apr. 2020, emcrit.org/ibcc/covid19/#labs. Guan W. et al. Clinical Characteristics of Coronavirus Disease 2019 in China. February 28, 2020, updated on March 6, 2020, at NEJM.org. DOI: 10.1056/NEJMoa2002032 Summarized by Jackson Roos, MS4 | Edited by Erik Verzemnieks, MD