What radiologists need to know about the deadly coronavirus outbreak

With the deadly 2019 coronavirus now making its way to U.S. shores, radiologists and other clinicians will need to remain vigilant for this new indication, health officials said this week.

The Centers for Disease Control and Prevention has now reported five total cases of the virus in Arizona, California, Illinois and Washington, with dozens more under investigation. Coronavirus originated in Wuhan, China, killing at least 100 individuals overseas and infecting another 4,500-plus as of late Monday.

As more reports continue to emerge in the state, Chinese scientists have detailed some of their early findings on the outbreak to help inform diagnosticians across the globe.  In a Lancet study published Friday, Jan. 24, officials reported that common symptoms at onset of the illness include fever, cough and fatigue.

All 41 patients in the analysis had pneumonia and abnormal findings on chest CT, scientists noted. The outbreak has been associated with intensive care unit admission, they reported, along with high mortality.

“Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfillment by future studies,” the team, led by Chaolin Huang, with the Jin Yin-tan Hospital in Wuhan, wrote Friday. Huang added that this could only be “the tip of the iceberg” as the outbreak continues to unfold.

At admission, all 41 patients in the analysis had abnormalities in their chest CT scans. Of those, 40 had bilateral involvement. Typical imaging findings in the ICU included bilateral multiple lobular and subsegmental areas of consolidation. While those who were not admitted to the ICU showed bilateral ground-glass opacity and subsegmental areas of consolidation in CT images. Six of the patients have now died, with 28 discharged.

Another Jan. 24 study in the New England Journal of Medicine further explores chest radiographs and key clues for radiologists, including two specific patient cases.

The CDC has also issued interim guidance for clinicians to prepare in the event that the virus arrives at their own doorstep. They’ve labeled the outbreak as a “very serious public health situation” that could worsen.

“It is likely there will be more cases reported in the U.S. in the coming days and weeks, likely including person-to-person spread,” the CDC reported Sunday.