The importance of radiological findings in the management of patients with COVID-19: A literature review
INTRODUCTION: COVID-19 has been imposing great challenges for the maintenance of global stability due to the pandemics. Even with the overwhelming progression of the disease, the physiopathology of the Acute Respiratory Syndrome is still not well known, presenting inconclusions regarding the caused complications and the main diagnostic findings by imaging exams of the thoracic region, as it leads to an impairment of the respiratory pathways. AIM: To study the importance and the impact caused by COVID-19 through the different radiological findings. MATERIAL AND METHOD: This paper is an integrative review. The SciELO and PUBMED databases were used and the search was performed with the descriptors “diagnostic imaging” and “COVID-19”. Seven articles published in Brazil in 2020 were selected, they were published in Portuguese. In addition to the inclusion criteria, only those relevant to the study were used. RESULTS: Although the polymerase chain reaction with reverse transcriptase (RT-PCR) is the gold standard for definitive diagnosis, it still presents several problems inherent to its use and management, making it inaccessible to the entire population. Thus, chest X-ray findings are viable alternatives in the identification of respiratory comorbidities, with high sensitivity. The main findings, in early stages, by radiographic images reveal: alveolar changes with bilateral or multifocal ground-glass opacities, septal spacing, reticular changes and peripheral distribution in the middle, lower and posterior lung portions, in addition, lung scars and pleural effusions can be found in more stages advanced. Regarding computed tomography, it should not be used for screening COVID-19 in asymptomatic patients. In hospitalized, symptomatic cases or in specific clinical situations, the findings of ground-glass opacity, reversed halo sign, lymphadenopathies, and air bronchogram can be found. However, they are still nonspecific and similar to other pulmonary infections and must be correlated with clinical and laboratory evidence. CONCLUSION: Due to the scarcity of studies and the presence of many inconclusions on the subject, the diagnosis by RT-PCR, although used for the definitive diagnosis, can be assisted by imaging exams to assess the extent of the disease, possible complications and in the form of an alternative diagnostic tool. In short, this data is of great importance for the medical team, which must provide radiological references for building consensus and guidelines, to establish an effective medical practice, in the context of a pandemic situation.
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