Fast Five Quiz: Severe Acute Respiratory Syndrome (SARS)

Michael Stuart Bronze, MD

Disclosures

May 04, 2020

In the 2002-2003 outbreak, initial chest radiography findings were found to be abnormal in approximately 60% of patients. Abnormalities on chest radiographs were observed in serial examinations in nearly all patients by 10-14 days after symptom onset.

Interstitial infiltrates can be observed early in the disease course, although in the early stage, a peripheral, pleural-based opacity (ranging from ground-glass opacification to frank consolidation) may be the only abnormality. HRCT scanning of the chest during this time may reveal an infiltrate in the retrocardiac region. The role of HRCT scanning in the evaluation of SARS is still controversial. Patients with abnormal chest radiographic findings do not need HRCT scanning. However, when SARS is a strong clinical possibility despite a normal chest radiographic finding, the clinician should consider HRCT scanning. MRI does not have a recognized role in SARS.

In patients with COVID-19, chest radiography may reveal pulmonary infiltrates. Chest CT scanning in patients with COVID-19–associated pneumonia usually shows ground-glass opacification, possibly with consolidation. Some studies have reported that abnormalities on chest CT scans are usually bilateral, involve the lower lobes, and have a peripheral distribution. Pleural effusion, pleural thickening, and lymphadenopathy have also been reported, although with less frequency.

Read more about imaging studies in SARS.

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