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The pandemic COVID-19 caused by the 2019 novel coronavirus called severe acute respiratory syndrome coronavirus-2 displays a very heterogeneous clinical behaviour. The majority of patients (>85%) are asymptomatic or have mild symptoms, while few others show a very aggressive and life-threatening disease. Imaging spectrum of COVID-19 is very heterogenous as well: from normal picture in patients with mild symptoms such as fever and dry cough (figures 1 and 2) to pneumonia with multiple patchy, peripheral, bilateral areas of ground-glass opacity (GGO) and consolidation as in more severe illness (figures 3–8). A quick evolution of the disease is also seen. Involvement of both lungs seems to be the main imaging feature (75–100% of cases)1 2 usually with GGOs (77–91%)1 3 and consolidations (55–69%)1 3 in peripheral regions. Pleural effusions may occur in a minority of cases (4.1% of cases vs 39% in non-COVID-19 viral pneumonia)1; lymphadenopathy is rare, and pulmonary nodules and cavitation are not described.1–3 These imaging characteristics must be taken into account because they may help clinicians to better diagnose COVID-19 especially in an early phase4 and differentiate it from other viral cases of pneumonia (central distribution of lesions was observed in 80% vs 57% of cases in non-COVID-19 viral pneumonia in one study)1 or bacterial infections (usually with lobar or segmental consolidation).5
Contributors GDA, AC, FS, RV, VB, MG followed patients and wrote the paper. AL performed diagnostic imaging. All authors reviewed and approved the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; internally peer reviewed.