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Coronavirus
Santiago Martínez-Jiménez, MD; Melissa L. Rosado de Christenson, MD, FACR; Sherief H. Garrana, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Human coronavirus (HCoV)
            • Definitions

              • RNA virus initially described in 1960s
                • Order: Nidovirales
                • Family: Coronaviridae
                • Genus: Coronavirus
              • Respiratory and enteric disease in humans and other animals
              • Genera: Alpha, beta, gamma, and delta
                • HCoV
                  • Alpha coronavirus: HCoV-229E, HCoV-NL63
                  • Beta coronavirus: HCoV-HKU1, HCoV-OC43, Middle East respiratory syndrome coronavirus (MERS-CoV), severe acute respiratory syndrome coronavirus (SARS-CoV), 2019 novel coronavirus disease (COVID-19)
                • Gamma coronavirus (avian): Infectious bronchitis in chickens
                • Delta coronavirus (birds)
              • Community-acquired coronavirus: HCoV-229E, HCoV-NL63, HCoV-HKU1, HCoV-OC43
              • Epidemics: MERS-CoV, SARS-CoV, COVID-19 (SARS-CoV-2)

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      • Microscopic Features

                        CLINICAL ISSUES

                        • Presentation

                          • Demographics

                            • Natural History & Prognosis

                              • Treatment

                                • Laboratories

                                  DIAGNOSTIC CHECKLIST

                                  • Consider

                                    Selected References

                                    1. Bernheim A et al: Chest CT findings in coronavirus disease-19 (COVID-19): relationship to duration of infection. Radiology. 200463, 2020
                                    2. Huang C et al: Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 395(10223):497-506, 2020
                                    3. UpToDate: COVID-19: Epidemiology, virology, and prevention. Reviewed May 27, 2021. Accessed May 27, 2021. https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19
                                    4. Kanne JP et al: Essentials for radiologists on COVID-19: an update. Radiology scientific expert panel. Radiology. 200527, 2020
                                    5. Li Q et al: Early transmission dynamics in Wuhan, China of novel coronavirus-infected pneumonia. N Engl J Med. 382(13):1199-207, 2020
                                    6. Mehta P et al: COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 395(10229):1033-1034, 2020
                                    7. Novel Coronavirus Information Center: Elsevier's free health and medical research on novel coronavirus (2019-nCoV). Reviewed February 10, 2020. Accessed February 10, 2020. https://www.elsevier.com/connect/coronavirus-information-center
                                    8. Paules CI et al: Coronavirus infections--more than just the common cold. JAMA. 323(8):707-8, 2020
                                    9. Salehi S et al: Coronavirus disease 2019 (COVID-19): a systematic review of imaging findings in 919 patients. AJR Am J Roentgenol. 215(1):87-93, 2020
                                    10. Shi H et al: Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect Dis. 20(4):425-34, 2020
                                    11. Tian S et al: Pulmonary pathology of early phase 2019 novel coronavirus (COVID-19) pneumonia in two patients with lung cancer. J Thorac Oncol. 15(5):700-4, 2020
                                    12. Alsaad KO et al: Histopathology of Middle East respiratory syndrome coronovirus (MERS-CoV) infection - clinicopathological and ultrastructural study. Histopathology. 72(3):516-24, 2018
                                    13. Burk M et al: Viral infection in community-acquired pneumonia: a systematic review and meta-analysis. Eur Respir Rev. 25(140):178-88, 2016
                                    14. Das KM et al: Middle East respiratory syndrome coronavirus: what does a radiologist need to know? AJR Am J Roentgenol. 206(6):1193-201, 2016
                                    15. Ng DL et al: Clinicopathologic, immunohistochemical, and ultrastructural findings of a fatal case of Middle East respiratory syndrome coronavirus infection in the United Arab Emirates, April 2014. Am J Pathol. 186(3):652-8, 2016
                                    16. Das KM et al: CT correlation with outcomes in 15 patients with acute Middle East respiratory syndrome coronavirus. AJR Am J Roentgenol. 204(4):736-42, 2015
                                    17. Fehr AR et al: Coronaviruses: an overview of their replication and pathogenesis. Methods Mol Biol. 1282:1-23, 2015
                                    18. Müller MA et al: Presence of Middle East respiratory syndrome coronavirus antibodies in Saudi Arabia: a nationwide, cross-sectional, serological study. Lancet Infect Dis. 15(5):559-64, 2015
                                    19. Ajlan AM et al: Middle East respiratory syndrome coronavirus (MERS-CoV) infection: chest CT findings. AJR Am J Roentgenol. 203(4):782-7, 2014
                                    20. Kell DB et al: Serum ferritin is an important inflammatory disease marker, as it is mainly a leakage product from damaged cells. Metallomics. 6(4):748-73, 2014
                                    21. Franquet T: Imaging of pulmonary viral pneumonia. Radiology. Jul;260(1):18-39, 2011
                                    22. Woo PC et al: Clinical features and molecular epidemiology of coronavirus-HKU1-associated community-acquired pneumonia. Hong Kong Med J. 15 Suppl 9:46-7, 2009
                                    23. Falsey AR: Community-acquired viral pneumonia. Clin Geriatr Med. 23(3):535-52, vi, 2007
                                    24. Ketai L et al: Radiology of severe acute respiratory syndrome (SARS): the emerging pathologic-radiologic correlates of an emerging disease. J Thorac Imaging. 21(4):276-83, 2006
                                    25. Kahn JS et al: History and recent advances in coronavirus discovery. Pediatr Infect Dis J. 24(11 Suppl):S223-7, discussion S226, 2005
                                    26. Peiris JS et al: Coronavirus as a possible cause of severe acute respiratory syndrome. Lancet. 361(9366):1319-25, 2003
                                    27. Wong KT et al: Thin-section CT of severe acute respiratory syndrome: evaluation of 73 patients exposed to or with the disease. Radiology. 228(2):395-400, 2003
                                    28. Pene F et al: Coronavirus 229E-related pneumonia in immunocompromised patients. Clin Infect Dis. 37(7):929-32, 2003
                                    29. Rota PA et al: Characterization of a novel coronavirus associated with severe acute respiratory syndrome. Science. 300(5624):1394-9, 2003
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Top Differential Diagnoses

                                          • Pathology

                                            • Clinical Issues

                                              TERMINOLOGY

                                              • Abbreviations

                                                • Human coronavirus (HCoV)
                                              • Definitions

                                                • RNA virus initially described in 1960s
                                                  • Order: Nidovirales
                                                  • Family: Coronaviridae
                                                  • Genus: Coronavirus
                                                • Respiratory and enteric disease in humans and other animals
                                                • Genera: Alpha, beta, gamma, and delta
                                                  • HCoV
                                                    • Alpha coronavirus: HCoV-229E, HCoV-NL63
                                                    • Beta coronavirus: HCoV-HKU1, HCoV-OC43, Middle East respiratory syndrome coronavirus (MERS-CoV), severe acute respiratory syndrome coronavirus (SARS-CoV), 2019 novel coronavirus disease (COVID-19)
                                                  • Gamma coronavirus (avian): Infectious bronchitis in chickens
                                                  • Delta coronavirus (birds)
                                                • Community-acquired coronavirus: HCoV-229E, HCoV-NL63, HCoV-HKU1, HCoV-OC43
                                                • Epidemics: MERS-CoV, SARS-CoV, COVID-19 (SARS-CoV-2)

                                              IMAGING

                                              • General Features

                                                • Radiographic Findings

                                                  • CT Findings

                                                    DIFFERENTIAL DIAGNOSIS

                                                      PATHOLOGY

                                                      • General Features

                                                        • Microscopic Features

                                                          CLINICAL ISSUES

                                                          • Presentation

                                                            • Demographics

                                                              • Natural History & Prognosis

                                                                • Treatment

                                                                  • Laboratories

                                                                    DIAGNOSTIC CHECKLIST

                                                                    • Consider

                                                                      Selected References

                                                                      1. Bernheim A et al: Chest CT findings in coronavirus disease-19 (COVID-19): relationship to duration of infection. Radiology. 200463, 2020
                                                                      2. Huang C et al: Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 395(10223):497-506, 2020
                                                                      3. UpToDate: COVID-19: Epidemiology, virology, and prevention. Reviewed May 27, 2021. Accessed May 27, 2021. https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19
                                                                      4. Kanne JP et al: Essentials for radiologists on COVID-19: an update. Radiology scientific expert panel. Radiology. 200527, 2020
                                                                      5. Li Q et al: Early transmission dynamics in Wuhan, China of novel coronavirus-infected pneumonia. N Engl J Med. 382(13):1199-207, 2020
                                                                      6. Mehta P et al: COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 395(10229):1033-1034, 2020
                                                                      7. Novel Coronavirus Information Center: Elsevier's free health and medical research on novel coronavirus (2019-nCoV). Reviewed February 10, 2020. Accessed February 10, 2020. https://www.elsevier.com/connect/coronavirus-information-center
                                                                      8. Paules CI et al: Coronavirus infections--more than just the common cold. JAMA. 323(8):707-8, 2020
                                                                      9. Salehi S et al: Coronavirus disease 2019 (COVID-19): a systematic review of imaging findings in 919 patients. AJR Am J Roentgenol. 215(1):87-93, 2020
                                                                      10. Shi H et al: Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect Dis. 20(4):425-34, 2020
                                                                      11. Tian S et al: Pulmonary pathology of early phase 2019 novel coronavirus (COVID-19) pneumonia in two patients with lung cancer. J Thorac Oncol. 15(5):700-4, 2020
                                                                      12. Alsaad KO et al: Histopathology of Middle East respiratory syndrome coronovirus (MERS-CoV) infection - clinicopathological and ultrastructural study. Histopathology. 72(3):516-24, 2018
                                                                      13. Burk M et al: Viral infection in community-acquired pneumonia: a systematic review and meta-analysis. Eur Respir Rev. 25(140):178-88, 2016
                                                                      14. Das KM et al: Middle East respiratory syndrome coronavirus: what does a radiologist need to know? AJR Am J Roentgenol. 206(6):1193-201, 2016
                                                                      15. Ng DL et al: Clinicopathologic, immunohistochemical, and ultrastructural findings of a fatal case of Middle East respiratory syndrome coronavirus infection in the United Arab Emirates, April 2014. Am J Pathol. 186(3):652-8, 2016
                                                                      16. Das KM et al: CT correlation with outcomes in 15 patients with acute Middle East respiratory syndrome coronavirus. AJR Am J Roentgenol. 204(4):736-42, 2015
                                                                      17. Fehr AR et al: Coronaviruses: an overview of their replication and pathogenesis. Methods Mol Biol. 1282:1-23, 2015
                                                                      18. Müller MA et al: Presence of Middle East respiratory syndrome coronavirus antibodies in Saudi Arabia: a nationwide, cross-sectional, serological study. Lancet Infect Dis. 15(5):559-64, 2015
                                                                      19. Ajlan AM et al: Middle East respiratory syndrome coronavirus (MERS-CoV) infection: chest CT findings. AJR Am J Roentgenol. 203(4):782-7, 2014
                                                                      20. Kell DB et al: Serum ferritin is an important inflammatory disease marker, as it is mainly a leakage product from damaged cells. Metallomics. 6(4):748-73, 2014
                                                                      21. Franquet T: Imaging of pulmonary viral pneumonia. Radiology. Jul;260(1):18-39, 2011
                                                                      22. Woo PC et al: Clinical features and molecular epidemiology of coronavirus-HKU1-associated community-acquired pneumonia. Hong Kong Med J. 15 Suppl 9:46-7, 2009
                                                                      23. Falsey AR: Community-acquired viral pneumonia. Clin Geriatr Med. 23(3):535-52, vi, 2007
                                                                      24. Ketai L et al: Radiology of severe acute respiratory syndrome (SARS): the emerging pathologic-radiologic correlates of an emerging disease. J Thorac Imaging. 21(4):276-83, 2006
                                                                      25. Kahn JS et al: History and recent advances in coronavirus discovery. Pediatr Infect Dis J. 24(11 Suppl):S223-7, discussion S226, 2005
                                                                      26. Peiris JS et al: Coronavirus as a possible cause of severe acute respiratory syndrome. Lancet. 361(9366):1319-25, 2003
                                                                      27. Wong KT et al: Thin-section CT of severe acute respiratory syndrome: evaluation of 73 patients exposed to or with the disease. Radiology. 228(2):395-400, 2003
                                                                      28. Pene F et al: Coronavirus 229E-related pneumonia in immunocompromised patients. Clin Infect Dis. 37(7):929-32, 2003
                                                                      29. Rota PA et al: Characterization of a novel coronavirus associated with severe acute respiratory syndrome. Science. 300(5624):1394-9, 2003