Diagnóstico diferencial con TC

It is important to note that the current differential diagnosis of COVID-19 is made by RT-PCR (reverse transcription-polymerase chain reaction). Nevertheless, CT scans can be indicative of COVID-19 in severe cases, during RT-PCR wait times before PCR results are obtained.

Patterns not usually found in COVID-19

They can also be associated with different types of infectious diseases and pneumonia

Even though common chest CT is very sensitive to COVID-19, the typical patterns are not exclusive for the disease (low specificity). These can also be found in:

Viral pneumonia (Influenza i Adenovirus)
Non-infectious conditions

Chest CT scan is sensitive to severe cases of COVID-19, but not specific.

How to diagnose an infection by Adenovirus in chest CT

Chest CT for confirmed Adenovirus infected patient:

Diffuse ground-glass opacity pattern
Segmental and subpleural bilateral consolidation
Pleural effusion

In some cases, their patterns can be similar to chest CT findings in patients with COVID-19. This further refelects the lack of specificty chest CT has for COVID-19.

Clinical case

58-year-old female with an Adenovirus infection

Subpleural ground-glass opacity
Consolidation with vascular ampliation
Interlobular septal thickening
Air bronchogram

Bibliography

Dai, W., Zhang, H., Yu, J., Xu, H., Chen, H., Luo, S., … Lin, F. (2020). CT Imaging and Differential Diagnosis of COVID-19. Canadian Association of Radiologists Journal, 084653712091303. https://doi.org/10.1177/0846537120913033
Jin, Y. H., Cai, L., Cheng, Z. S., Cheng, H., Deng, T., Fan, Y. P., … Wang, X. H. (2020, February 6). A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Military Medical Research. BioMed Central Ltd. https://doi.org/10.1186/s40779-020-0233-6
Li, Y., & Xia, L. (2020). Coronavirus Disease 2019 (COVID-19): Role of Chest CT in Diagnosis and Management. American Journal of Roentgenology, 1–7. https://doi.org/10.2214/AJR.20.22954
Molero JM, Redondo J. SEMFYC WEBINAR COVID19. https://www.semfyc.es/wp-content/uploads/2020/03/covid-19-semFYC-webinar20200319.pdf
Zu, Z. Y., Jiang, M. Di, Xu, P. P., Chen, W., Ni, Q. Q., Lu, G. M., & Zhang, L. J. (2020). Coronavirus Disease 2019 (COVID-19): A Perspective from China. Radiology, 200490. https://doi.org/10.1148/radiol.2020200490