Correct!
5. CT pulmonary angiography shows progression of the pulmonary abnormalities seen previously (Figure 3)

The CT pulmonary angiogram shows no evidence of acute or chronic thromboembolic disease and no pleural abnormalities are present. While CT pulmonary angiography cannot exclude myocarditis or ischemic heart disease, there is no visible coronary calcium, no pericardial effusion is present, and the myocardium appears to enhance normally. The pulmonary opacities seen at the initial unenhanced chest CT (Figure 3) have worsened, showing an overall greater extent and transitioning from a more “pure” ground-glass opacity appearance to a more consolidative appearance.

The patient was readmitted and isolated. Over the next two days, his remained afebrile and his shortness of breath and chest pain improved. His oxygenation improved to 98% on room air. The patient was discharged home with instructions to continue quarantining for 14 days, given his persistent positive COVID-19 testing.

Diagnosis:  COVID-19 (Coronavirus Disease 2019 / SARS-CoV-2) pneumonia

References

  1. Rubin GD, Ryersin C, Hamarati LB, et al.The role of chest imaging in patient management during the COVID-19 pandemic: a multinational consensus statement from the Fleischner Society. Chest. 2020 Apr 7. pii: S0012-3692(20)30673-5. [CrossRef] [PubMed]
  2. Hope MD, Raptis CA, Henry TS. Chest computed tomography for detection of coronavirus disease 2019 (COVID-19): don't rush the science. Ann Intern Med. 2020; Apr 8:M20-1382. [CrossRef] [PubMed]
  3. Bao C, Liu X, Zhang H, Li Y, Liu J. Coronavirus disease 2019 (COVID-19) CT findings: a systemic review and meta-analysis. J Am Coll Radiol. 2020 Mar 25. pii: S1546-1440(20)30262-3. [CrossRef] [PubMed]
  4. Bernheim A, Mei X, Huang M, et al. Chest CT findings in coronavirus disease-19 (COVID-19): relationship to duration of infection. Radiology. 2020 Feb 20:200463. [CrossRef] [PubMed]
  5. Chung M, Bernheim A, Mei X, et al. CT imaging features of 2019 novel coronavirus (2019-nCoV). Radiology. 2020 Apr;295(1):202-7. [CrossRef] [PubMed]
  6. Han X, Cao Y, Jiang N, et al. Novel coronavirus pneumonia (COVID-19) progression course in 17 discharged patients: comparison of clinical and thin-section CT features during recovery. Clin Infect Dis. 2020 Mar 30. pii: ciaa271. [CrossRef] [PubMed]
  7. Huang G, Gong T, Wang G, et al. Timely diagnosis and treatment shortens the time to resolution of coronavirus disease (COVID-19) pneumonia and lowers the highest and last CT scores from sequential chest CT. AJR Am J Roentgenol. 2020 Mar 30:1-7. [CrossRef] [PubMed]

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