Multimodality imaging in COVID-19 patients: A key role from diagnosis to prognosis

D'Andrea, Antonello; Radmilovic, Juri; Carbone, Andreina; Forni, Alberto; Tagliamonte, Ercole; Riegler, Lucia; Liccardo, Biagio; Crescibene, Fabio; Sirignano, Cesare; Esposito, Giovanna; Bossone, Eduardo

The integrated clinical, laboratory and ultrasound approach is essential for the diagnosis, evaluation and monitoring of the patient's therapy in coronavirus disease 2019 pneumonia. The ideal imaging approach in this context is not yet well defined. Chest X-ray is characterized by low sensitivity in identifying earlier lung changes. The "bedside" pulmonary ultrasound has an undeniable series of advantages in the patient at high infectious risk and can provide incremental data in the respiratory intensive care for the serial control of the individual patient as well as for the home delivery of the stabilized subjects. Pulmonary computed tomography shows high sensitivity but should not be routinely performed in all patients, because in the first 48 h it can be absolutely negative and in the late phase the imaging findings may not change the therapeutic approach. Echocardiography should be limited to patients with hemodynamic instability to assess ventricular function and pulmonary pressures.