新型冠状病毒肺炎初诊临床特征及高分辨率CT影像表现

目的 探讨新型冠状病毒肺炎(COVID-19)患者初诊临床特征及胸部高分辨率CT(HRCT)影像表现。方法 回顾性搜集2020年1月20日至28日武汉大学人民医院经临床及核酸检测确诊的141例COVID-19患者,男77例,女64例,中位年龄49(9, 87)岁。分析141例COVID-19患者的临床特征、实验室检查指标以及胸部HRCT影像学表现。结果 141例COVID-19患者实验室检查发现白细胞计数降低38例(26.95%)、淋巴细胞比率降低71例(50.35%)。141例COVID-19患者中发热(>37.5 ℃) 139例(98.58%)、咳嗽106例(75.18%)、头痛11例(7.80%)、咳痰41例(29.08%)、胸闷93例(65.96%)、呼吸道以外症状主要有腹泻等4例(2.84%)。141例COVID-19患者HRCT均有异常,52例(36.88%)胸部HRCT图像表现为磨玻璃影(GGO)和斑片影,以胸膜下分布为主;23例(16.31%)GGO合并局灶实变影;27例(19.15%)小片状模糊影;20例(14.18%)大片状实变影;48例(34.04%)支气管血管束增粗和血管穿行征;5例(3.55%)有空气支气管征象;7例(4.96%)小结节影;5例(3.55%)纤维化、网格影或条索影;7例(4.96%)双侧胸腔积液,4例(2.84%)纵隔或双侧肺门淋巴结肿大。结论 COVID-19的临床特征及HRCT影像表现多样,在COVID-19特定的流行病学背景下,应及时开展胸部HRCT扫描,对疾病做出早期预警。     

新型冠状病毒肺炎首次胸部高分辨率CT影像分析

目的 探讨新型冠状病毒肺炎(COVID-19)首次胸部高分辨率CT(HRCT)影像表现。方法 回顾性分析2020年1月3日至25日武汉市中西医结合医院确诊的106例COVID-19患者的首次胸部HRCT图像,对病灶分布、形态及周围受累情况进行统计和分析。结果 106例COVID-19患者首次肺部HRCT均发现病灶,单侧肺分布11例(10.4%),双侧肺分布95例(89.6%);肺外周分布65例(61.3%),肺外周及中心同时分布41例(38.7%);1个病灶8例(7.5%),2个病灶5例(4.7%),多发病灶93例(87.8%);结节状病灶12例(11.3%),磨玻璃状病灶94例(88.7%),条索状病灶7例(6.6%),2种及以上形态共存病灶15例(14.2%);累及一个肺叶10例(9.4%),累及2个及以上肺叶96例(90.6%);纵隔淋巴结增大24例(22.6%)(>60岁患者19例,占79.2%),胸腔积液3例(2.8%),心包积液1例(0.9%),胸膜受累/增厚2例(1.9%)。>60岁患者多表现为多病灶,多形态,肺外周及中心同时分布,累及多个肺叶,纵隔淋巴结增大。结论 COVID-19患者首次胸部HRCT检查能发现肺部病灶,是首选的影像学检查方法,胸部HRCT扫描检查在NCP的早期诊断中有重要作用。     

新型冠状病毒肺炎胸部高分辨率CT影像分期与鉴别

目的探讨新型冠状病毒肺炎(COVID-19)胸部高分辨率CT(HRCT)影像分期与鉴别。方法回顾性分析50例临床确诊为COVID-19患者的临床资料及胸部HRCT图像,HRCT图像分析内容包括:病灶分布、范围、形态、密度、实变、磨玻璃影、支气管血管束增厚等。结果 COVID-19胸部HRCT主要表现可分为早期、进展期、重症期、恢复期:1)早期双肺散在、多发斑片状、节段或亚段性磨玻璃密度影(GGO),以肺外周或胸膜下分布为主,可见空气支气管征及血管增粗穿行;2)进展期病灶范围融合增大,累及多个肺段、肺叶呈"反蝶翼"征,可见小叶间隔增厚呈"铺路石"征;少数出现胸膜增厚、胸腔积液、淋巴结肿大或小空洞;3)重症期:双肺弥漫GGO合并实变影,见支气管充气征,可至"白肺";4)恢复期病灶范围缩小,实变灶逐渐消失,部分残留纤维条索影。结论 COVID-19患者胸部HRCT具有特征性表现,其中以双肺外周、胸膜下散在磨玻璃影(GGO)最具特征,可进展至双肺实变或"白肺",治疗后病灶可吸收或残留条索影。     

75例新型冠状病毒肺炎病人首诊CT表现与检验结果分析

目的探讨新型冠状病毒肺炎(COVID-19)病人首诊胸部CT特征性表现,评价CT评分与临床检验结果的相关性。方法回顾性分析75例确诊COVID-19病人首诊胸部CT、发病时间及临床检验结果。由2名高年资影像诊断医师进行阅片,CT异常表现包括单发或多发磨玻璃影(GGO)或实变影,单肺或双肺受累,分布以胸膜下为主或肺中央为主。同时对COVID-19胸部CT表现进行半定量CT评分,采用Spearman相关分析比较CT评分与发病时间、淋巴细胞计数、中性粒细胞计数及C反应蛋白(CRP)的相关性。结果75例COVID-19首诊胸部CT正常者4例(5.33%),异常者71例(94.67%)。影像表现为多发GGO(26例,36.62%)、多发实变为主伴GGO(25例,35.21%)、多发GGO为主伴部分实变(12例,16.90%)、单发或散在GGO(8例,11.27%)。多数病人双肺受累(65例,91.55%),少数为单肺受累(6例,8.45%)。病变多位于胸膜下(66例,92.96%),少数位于肺内(5例,7.04%)。首诊CT评分与发病时间(rs=0.701,P<0.05)和CRP呈正相关(rs=0.522,P<0.05),与淋巴细胞计数呈负相关(rs=-0.303,P<0.05),与中性粒细胞计数无明显相关性(P>0.05)。结论COVID-19首诊胸部CT表现具有一定特征性,且与淋巴细胞计数、CRP有一定相关性,可能对临床预后有提示作用。     

新型冠状病毒肺炎的多层螺旋CT表现及动态观察

目的探讨新型冠状病毒肺炎(COVID-19)的胸部影像学征象及治疗前后动态变化。方法回顾性分析18例COVID-19患者的胸部MSCT表现,观察病变的影像学特点及治疗前后动态变化。结果胸部MSCT表现及动态变化特点1)18例患者中胸部影像表现阴性2例;2)双肺分布12例(67%),累及多个肺叶9例(50%),呈外周及中心同时分布8例(44%),病灶多处13例(72%);3)病灶形态多样磨玻璃影15例(83%),实变影5例(28%),网格影5例(28%),两者以上5例(28%);4)病灶内部形态支气管血管束增粗3例(17%),血管穿行6例(33%),空气支气管征5例(28%);5)治疗前后对比观察确诊患者治疗后3天内复查实变影变淡8例(44%),磨玻璃影局部密度变实9例(50%),单发磨玻璃结节影边界变清晰、密度增高1例(6%),多发磨玻璃结节影范围增大、呈簇状改变1例(6%),网格影密度增高、范围略减小5例(28%),另有新发斑片影2例(11%);6天内复查,实变影进一步吸收、可见反晕征8例(44%),实变区域增多10例(56%),单发实性结节形成1例(6%),磨玻璃影密度进一步减低、其内血管影明显9例(50%),网格影范围减小、呈条状改变,边界清晰5例(28%),部分新发斑片影融合2例(11%),胸腔积液较前减少1例(6%);10天以上复查,肺内斑片影完全吸收18例(100%),实变影范围减小,呈纤维化改变16例(89%),实变结节密度变淡,周围见晕征1例(6%)。结论COVID-19胸部MSCT表现有一定特征性,影像学检查与诊断仍是其临床诊断、疗效评价、预后分析的重要方法。     

HRCT在新型冠状病毒肺炎诊断中的应用

目的探究常规CT以及HRCT对新型冠状病毒肺炎(COVID-19)检查中的影像学表现差异,分析HRCT的特异性影像学特征。方法回顾性分析经核酸检测阳性确诊的新型冠状病毒肺炎患者37例,先采用常规CT进行扫描,其中将肺部有渗出病变为CT阳性组,肺部无渗出病变患者为CT阴性组2例。然后针对CT阳性患者对病灶多平面重建和最大密度投影重建得出所有病灶HRCT图像。参照《新型冠状病毒肺炎的放射学诊断》1,推荐将CT影像分为早期、进展期、重症期和转归期,对不同期的HRCT及常规胸部CT的影像表现分别比较分析,找出影像表现差异。结果HRCT及常规CT影像学均表现为单侧肺或者双侧肺中外带肺野或胸膜下磨玻璃样病灶,分析常规CT及HRCT所有病灶中,病灶分布情况如下右肺上叶17例,右肺中叶18例,右肺下叶23例,左肺上叶19例,左肺下叶19例,其中双下肺分布25例(占71.4%),背侧分布26例(占74.3%)。形态特征磨玻璃,部分性或全实性,细网格、铺路石征,结节伴晕征,长轴与胸膜平行,空气支气管征,病灶沿支气管血管束分布,“增粗血管”征象。其中磨玻璃影、“细网格、铺路石”征象、结节伴晕征、“增粗血管”征象虽然在常规CT中可以显示,但HRCT通过薄层及三维重建能够清晰的显示出这种征象,其P值分别为0.006、0.008、0.042、0.035(P值<0.05),差异具有统计学意义。结论HRCT较常规CT扫描更能精确的显示出NCP的影像学细微特征,HRCT检查对新型冠状病毒肺炎患者的确诊具有十分重要意义。     

COVID-19发病首周胸部HRCT表现对疾病进展的预测价值

目的探讨新型冠状病毒肺炎(COVID-19)病人发病首周胸部高分辨力CT(HRCT)表现对疾病进展的预测价值。方法回顾性分析67例确诊COVID-19病人发病首周胸部HRCT影像及临床资料,男38例,女29例,平均(49.6±17.6)岁,根据病人病程进展情况分为疾病缓解组[55例,平均年龄(46.1±16.7)岁]和疾病进展组[12例,平均年龄(65.6±12.3)岁]。比较2组的一般临床资料及CT影像特征,分别采用卡方检验、t检验及Fisher确切概率检验比较性别、年龄及CT征象,采用Mann-Whitney U检验分析实验室检查结果及CT病变范围。采用Logistic回归检验分析差异有统计学意义的因素对于疾病进程的预测能力。结果 67例病人中,62例病人呈多肺叶胸膜下区分布并表现为磨玻璃密度影(GGO)(92.54%),多伴有肺实变(74.63%)及含气支气管征(80.6%);少见小叶核心结节、胸腔积液及心包积液。2组病人性别差异无统计学意义(P0.05)。与缓解组相比,进展组年龄更大、C反应蛋白(CRP)更高、受累肺叶更多、CT评分更高,更多出现胸膜增厚(均P0.05),其余CT征象差异均无统计学意义(均P0.05)。对年龄、CRP、受累肺叶、CT评分和胸膜增厚进行Logistic回归分析显示,病人年龄较大(OR=1.082,95%CI:1.018～1.149; P=0.011)及发病首周HRCT受累肺叶较多(OR=2.716,95%CI:1.086～6.790;P=0.033)是提示病人治疗中临床分型升级的独立影响因素。结论 COVID-19发病首周胸部CT表现具有一定特征,年龄大且受累肺叶多者病程中易发展为重症及危重症。     

新型冠状病毒肺炎亚临床期CT影像特征及短期演变

目的 探讨新型冠状病毒肺炎(COVID-19)亚临床期高分辨率CT(HRCT)特征及短期演变规律。方法 回顾性分析2020年1月15日至31日在华中科技大学同济医学院附属协和医院及武汉市金银潭医院确诊的17例亚临床期COVID-19患者的HRCT影像资料,男4例,女13例,年龄25.0~51.0(39.8±7.5)岁,均为与确诊COVID-19患者的密切接触者。所有患者首次CT检查后3~6 d再次行CT复查,其中6例患者复查前接受抗炎抗病毒及对症治疗,11例患者未进行任何治疗。分析亚临床期和短期随访的CT影像学征象,总结其短期随访CT图像演变规律。结果 17例COVID-19患者亚临床期及短期随访CT病变主要位于双肺下叶,亚临床期左肺下叶9例,右肺下叶10例;短期随访左肺下叶9例,右肺下叶11例;病变累及肺段由亚临床期的46个增加至90个肺段。亚临床期病变以多发为主(13例),短期复查多发病例减少(7例),局灶性(6例)及弥漫分布(4例)增多。病变主要分布于胸膜下(13例)和沿支气管血管束走行(10例),短期随访1例病变分布由胸膜下进展为胸膜下及沿支气管血管束走行。病变主要有3种形态:磨玻璃密度结节影、斑片状/片状/团片状磨玻璃影和铺路石征。亚临床期及短期复查均可见磨玻璃影,随访复查显示磨玻璃结节减少4例,铺路石征增加4例。6例患者治疗后短期复查,3例由多发磨玻璃结节变为单发磨玻璃结节,3例多发磨玻璃影部分范围变小。11例未治疗患者病变范围增大。结论 亚临床期COVID-19患者肺部CT具有一定特征,多为胸膜下或沿支气管血管束走行的小磨玻璃密度结节或磨玻璃影,短期随访病变变化较大。     

广州地区新型冠状病毒肺炎的高分辨率CT表现与临床特点

目的 初步探讨广州地区新型冠状病毒肺炎(COVID-19)的临床及首诊高分辨率CT(HRCT)影像表现特点。方法 回顾性分析2020年1月22日至30日广州市第八人民医院确诊的91例COVID-19患者,其中男39例、女52例,中位年龄50(33, 62)岁,分析91例COVID-19患者的临床及HRCT特点。结果 临床表现主要为发热70例,咳嗽57例,以干咳为主(39例)。首次HRCT有24例COVID-19患者呈阴性表现,67例HRCT有异常病灶,主要表现为肺内磨玻璃影65例、病灶内合并血管束增粗64例、病灶邻近胸膜增厚50例、间质间隔增厚47例、斑片影42例。所有患者均未见肿大淋巴结。病灶分布:双肺弥漫分布的2例,多发57例,单肺叶出现8例;病灶主要分布于胸膜下46例,肺下叶分布为著39例,上叶为著7例,在肺内无明显分布特征的有13例。结论 广州地区COVID-19早期影像主要表现为多发磨玻璃影,以胸膜下及下肺野多见,多有肺间质间隔的增厚,广州地区COVID- 19轻型及普通型患者比例较高,部分确诊患者首次HRCT呈阴性表现,对于HRCT呈阴性的患者,应及时复查。     

新型冠状病毒肺炎（COVID-19）的胸部CT表现与临床特点

【摘要】目的：分析新型冠状病毒肺炎（COVID-19）的CT表现与临床特点,提高对该病的认识。方法：回顾性分析41例临床诊断的COVID-19患者的临床及影像资料,男32例,女9例,平均年龄48.45岁。所有病例均经胸部CT检查,由两名高年资放射科医生对其影像学表现进行总结、分析。结果：COVID-19胸部CT主要表现为双肺磨玻璃样密度影、棉团状及网状小结节,双侧弥漫性分布,双下肺胸膜下为主,较双肺中上叶显著,右中叶受累相对少见。病程早期以肺外带、累及肺间质为主,多数病例可见细支气管充气征,可伴有粗大条索状影,胸膜下线。重症者随病程进展,病灶向支气管中轴间质蔓延,逐步扩散至全肺,可伴胸膜反应,叶间胸膜增厚、胸水少见。结论：COVID-19胸部CT表现具有一定特征性,结合临床流行性病学、临床症状、实验室检查可做早期临床诊断。     

HRCT检查新型冠状病毒肺炎的临床应用价值

目的探讨新型冠状病毒肺炎(COVID-19)CT表现及定量CT肺功能对COVID-19肺功能评估。方法回顾性分析31例经病毒核酸检测确诊、且具有完整动态胸部HRCT资料的COVID-19患者,复查间隔时间48 h~14天。分析HRCT基本表现及CT-肺功能成像与临床分型的关系。结果31例患者均于发病3天内接受HRCT检查,病变检出率为100%。于发病5~7天复查CT,25例病变范围增大,3例病灶范围缩小,3例病灶范围同前;发病10~14天接受第2次复查,26例病变范围缩小,3例病灶范围增大;临床分型与CT肺功能值(PI)(r=-0.835,P<0.001)呈显著负相关。结论胸部HRCT能清晰显示COVID-19疾病影像学变化,CT肺功能与COVID-19相关,有助于指导临床早诊断、早治疗,并可评价COVID-19的临床治疗效果。     

支气管侵袭性肺曲菌病HRCT诊断

目的 回顾性分析支气管侵袭性肺曲菌病的高分辨率CT(HRCT)表现,探讨HRCT在该病诊断中的价值.方法 收集30例经纤维支气管镜活检、CT导引下穿刺活检或痰培养证实的支气管侵袭性肺曲菌病的临床资料及影像学资料,所有HRCT图像均经2位经验丰富的胸部影像学主任医师阅片并分析总结其征象.结果 30例患者,19例具有多种CT征象,其中树芽征8例,支气管狭窄6例,支气管扩张8例,磨玻璃样密度灶(GGO)8例,腺泡结节10例,结节灶12例,腺泡结节灶伴有晕征4例,结节灶伴有晕征9例,空洞10例.11例具有单一CT征象,树芽征2例,支气管扩张2例,GGO 1例,腺泡结节2例,结节灶伴有晕征2例,空洞2例.30例病例中各征象出现率为:树芽征33.3%,支气管狭窄20%,支气管扩张33.3%,磨玻璃影30%,腺泡结节40%,结节灶46.6%,晕征53.3%,空洞40%.结论 支气管侵袭性肺曲菌病HRCT的主要征象是树芽征、支气管管腔狭窄或扩张,肺内见磨玻璃影、腺泡结节、结节灶,空洞,结节及空洞周围有晕征.支气管扩张合并树芽征、腺泡结节及晕征对诊断本病具有较高的特异性.     

新型冠状病毒肺炎儿童高分辨率CT表现

目的 探讨儿童新型冠状病毒肺炎(COVID-19)患者高分辨率CT(HRCT)表现。方法 回顾性分析2020年1月25日至2月5日华中科技大学同济医学院附属武汉儿童医院22例经临床及核酸检测确诊为COVID-19患儿的胸部HRCT表现。其中男12例,女10例,年龄2个月~14岁,中位年龄4岁,5岁以下患儿14例。由2名放射科医师共同观察肺部病变分布、形态、密度等特征及有无肺门、纵隔淋巴结肿大及胸膜改变。结果 22例患儿中,3例(3/22)肺部CT正常,19例(19/22)肺部HRCT见病灶浸润,其中单侧肺病变7例,双侧肺病变12例。HRCT表现为:磨玻璃影6例,其中淡磨玻璃影4例、典型铺路石征磨玻璃影2例;4例呈肺实变改变,表现为局限性条索影、斑片状高密度影;6例表现为实变影与磨玻璃影共存,呈斑片状致密影夹杂周围磨玻璃影改变,其中1例呈右侧白肺表现;3例呈类支气管肺炎改变,表现为肺叶内散在点状或斑片状密度不均高密度影。下叶病灶较上叶为重,肺外后带较肺尖部、中央区多见。全部患儿均未见肺门淋巴结增大和胸腔积液,1例见叶间胸膜增厚。结论 儿童COVID-19的HRCT表现多样化,需结合流行病学资料、临床表现及实验室检测综合判断,但肺部CT表现可作为临床早期诊断和防控干预的重要依据。     

Radiologist Reporting and Operational Management for Patients With Suspected COVID-19

PurposeThe aim of this study was to evaluate the adoption and outcomes of locally designed reporting guidelines for patients with possible coronavirus disease 2019 (COVID-19).MethodsA departmental guideline was developed for radiologists that specified reporting terminology and required communication for patients with imaging findings suggestive of COVID-19, on the basis of patient test status and imaging indication. In this retrospective study, radiology reports completed from March 1, 2020, to May 3, 2020, that mentioned COVID-19 were reviewed. Reports were divided into patients with known COVID-19, patients with “suspected” COVID-19 (having an order indication of respiratory or infectious signs or symptoms), and “unsuspected patients” (other order indications, eg, trauma or non–chest pain). The primary outcome was the percentage of COVID-19 reports using recommended terminology; the secondary outcome was percentages of suspected and unsuspected patients diagnosed with COVID-19. Relationships between categorical variables were assessed using the Fisher exact test.ResultsAmong 77,400 total reports, 1,083 suggested COVID-19 on the basis of imaging findings; 774 of COVID-19 reports (71%) used recommended terminology. Of 574 patients without known COVID-19 at the time of interpretation, 345 (60%) were eventually diagnosed with COVID-19, including 61% (315 of 516) of suspected and 52% (30 of 58) of unsuspected patients. Nearly all unsuspected patients (46 of 58) were identified on CT.ConclusionsRadiologists rapidly adopted recommended reporting terminology for patients with suspected COVID-19. The majority of patients for whom radiologists raised concern for COVID-19 were subsequently diagnosed with the disease, including the majority of clinically unsuspected patients. Using unambiguous terminology and timely notification about previously unsuspected patients will become increasingly critical to facilitate COVID-19 testing and contact tracing as states begin to lift restrictions.     

Typical CT findings of COVID-19 pneumonia in patients presenting with repetitive negative RT-PCR

Multiple polymerase chain reaction (RT-PCR) is considered the gold standard diagnostic investigation for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19).However, false negative multiple polymerase chain reaction (RT-PCR) results can be diagnostically challenging. We report three patients with history of fever and different clinical signs. During the height of the pandemic in Italy (March to May 2020), these patients underwent chest computed tomography (CT) scans that showed lung alterations typical of COVID-19 with multiple negative RT-PCR tests and positive serology for SARS-CoV-2. Two of the three patients showed residual pneumonia on CT after the onset of the first clinical signs. One patient presented with diarrhoea without respiratory symptoms. These cases suggest that in the COVID-19 pandemic period, to provide an earlier specific treatment in patients with positive serology, a chest CT scan can be useful in those presenting with a fever or a history of fever associated with persistent mild respiratory symptoms or with abdominal complaints despite repeated negative RT-PCR results.     

Radiografía de tórax pediátrica en la era COVID

BackgroundAn infectious disease caused by a new type of coronavirus that can manifest as an acute respiratory infection was discovered in China in mid-December 2019 and soon spread throughout the country and to the rest of the world. Although chest X-rays are the initial imaging technique of choice for low respiratory infections with or without dyspnea, few articles have reported the radiologic findings in children with COVID-19.ObjectiveTo describe the clinical, laboratory, and chest X-ray findings in pediatric patients with signs and symptoms of respiratory infection attended at our hospital in March 2020. To analyze the frequency of COVID-19 compared to other respiratory infections, and to describe the radiologic manifestations of COVID-19 in pediatric patients.Material and methodsThis cross-sectional observational study included all children with clinical manifestations of respiratory infection (fever, rhinorrhea, cough, and/or dyspnea) that required chest X-rays in our hospital between March 1 and March 31.ResultsA total of 231 pediatric patients (90 (39%) girls and 141 (61%) boys; mean age, 4 y, range 1 month – 16 years) underwent chest X-rays for suspected respiratory infections. Most (88.4%) had mild symptoms; 29.9% had a family member positive for COVID-19 with symptoms similar to those of the patient. Nasal and/or throat swabs were analyzed for SARS-CoV-2 with PCR in the 47 (20.3%) children who presented at the emergency department; 3 (6.3%) of these were positive. Microbiological analyses were done in 85 (36.8%) of all patients, finding infections due to pathogens other than SARS-CoV-2 in 30 (35.3%). One of the patients with a PCR positive for SARS-CoV-2 had urine infection due to E. coli and blood culture positive for S. viridans. Abnormalities were observed on X-rays in 73.2% of the patients. Peribronchial thickening was the most common abnormal finding, observed in 57% of patients. Parenchymal consolidations were observed in 38.5%, being bilateral in 29.2% and associated with pleural effusion in 3.3%. The interstitial lines were thickened in 7.3%, and 7.3% had ground-glass opacities.ConclusionDuring March 2020, COVID-19 and other symptomatic respiratory infections were observed. The radiologic pattern of these infections is nonspecific, and chest X-rays alone are insufficient for the diagnosis. Children with clinical manifestations compatible with COVID-19 (with or without PCR confirmation of infection by SARS-CoV-2) had mild symptoms and most did not require admission or invasive mechanical ventilation. In a context of community transmission, the absence of a known epidemiological antecedent should not be a contraindication for PCR to detect SARS-CoV-2.     

Incidental radiological findings suggestive of COVID-19 in asymptomatic patients

Despite routine screening of patients for coronavirus disease 2019 (COVID-19) symptoms and signs at hospital entrances, patients may slip between the cracks and be incidentally discovered to have lung findings that could indicate COVID-19 infection on imaging obtained for other reasons. Multiple case reports and case series have been published to identify the pattern of this highly infectious disease. This article addresses the radiographic findings in different imaging modalities that may be incidentally seen in asymptomatic patients who carry COVID-19. In general, findings of COVID-19 infection may appear in computed tomography (CT), magnetic resonance imaging, positron emission tomography-CT, ultrasound, or plain X-rays that show lung or only apical or basal cuts. The identification of these characteristics by radiologists and clinicians is crucial because this would help in the early recognition of cases so that a rapid treatment protocol can be established, the immediate isolation to reduce community transmission, and the organization of close monitoring. Thus, it is important to both the patient and the physician that these findings are highlighted and reported.