Incidental radiological findings suggestive of COVID-19 in asymptomatic patients

Abstract

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.

Keywords: Incidental; Asymptomatic COVID-19; Chest computed tomography; Positron emission tomography-computed tomography; Magnetic resonance imaging; Ultrasound; Oncology patients

Core Tip: Nowadays, the world is confronting a coronavirus disease 2019 (COVID-19) pandemic that has a major global influence on health, social, and economic issues. COVID-19 shows many different presentations with a wide range of severity. Because it is considered the most significant major health epidemic since that of the Spanish flu 100 years ago, the identification of all patterns of disease is extremely critical to protect the community and healthcare workers from such a highly contagious disease. Radiologists must be alert to recognize the different radiographic findings that suggest COVID-19, even in asymptomatic cases, in different imaging modalities.