Two in one: Overlapping CT findings of COVID-19 and underlying lung diseases

• Published in: Clinical imaging 2023-01, Vol.93, p.60-69
• Main Authors: Durhan, Gamze, Ardalı Düzgün, Selin, Baytar, Yusuf, Gülsün Akpınar, Meltem, Başaran Demirkazık, Figen, Arıyürek, Orhan Macit
• Format: Article
• Language: English
• Subjects: Abnormalities; Cardiothoracic Imaging; Chronic obstructive pulmonary disease; Complications; Computed tomography; Connective tissue diseases; Coronaviruses; COVID-19; COVID-19 - diagnostic imaging; COVID-19 pneumonia; Cysts; Diagnosis; Esophagus; Humans; Infections; Lung diseases; Lupus; Medical imaging; Mortality; Patients; Pneumonia; Pulmonary arteries; Radiologists; Radiology; Sarcoidosis; Severe acute respiratory syndrome coronavirus 2; Thorax; Tomography, X-Ray Computed; Viral diseases; Viral infections
• ISSN: 0899-7071; 1873-4499
• DOI: 10.1016/j.clinimag.2022.11.005

Coronavirus disease 2019 (COVID-19) is associated with pneumonia and has various pulmonary manifestations on computed tomography (CT). Although COVID-19 pneumonia is usually seen as bilateral predominantly peripheral ground-glass opacities with or without consolidation, it can present with atypical radiological findings and resemble the imaging findings of other lung diseases. Diagnosis of COVID-19 pneumonia is much more challenging for both clinicians and radiologists in the presence of pre-existing lung disease. The imaging features of COVID-19 and underlying lung disease can overlap and obscure the findings of each other. Knowledge of the radiological findings of both diseases and possible complications, correct diagnosis, and multidisciplinary consensus play key roles in the appropriate management of diseases. In this pictorial review, the chest CT findings are presented of patients with underlying lung diseases and overlapping COVID-19 pneumonia and the various reasons for radiological lung abnormalities in these patients are discussed. •The imaging features of COVID-19 and underlying lung disease can overlap and obscure the findings of each other.•Underlying lung disease can worsen the course of COVID-19 pneumonia and vice versa.•Knowing the imaging findings of COVID-19 and existing lung disease facilitates the differential diagnosis.