PDF(Pubmed)
Abstract：
Globally, many hospitalized COVID-19 patients can experience an unexpected acute change in status, prompting rapid and expert clinical assessment. Superimposed infections can be a significant cause of clinical and radiologic deviations in this patient population, further worsening clinical outcome and muddling the differential diagnosis. As thrombotic, inflammatory, and medication-induced complications can also trigger an acute change in COVID-19 patient status, imaging early and often plays a vital role in distinguishing the cause of patient decline and monitoring patient outcome. While the common radiologic findings of COVID-19 infection are now widely reported, little is known about the clinical manifestations and imaging findings of superimposed infection. By discussing case studies of patients who developed bacterial, fungal, parasitic, and viral co-infections and identifying the most frequently reported imaging findings of superimposed infections, physicians will be more familiar with common infectious presentations and initiate a directed workup sooner. Ultimately, any abrupt changes in the expected COVID-19 imaging presentation, such as the presence of new consolidations or cavitation, should prompt further workup to exclude superimposed opportunistic infection.
摘要：
全球范围内,许多住院的COVID-19患者会出现意想不到的急性状态变化，促进快速和专家的临床评估。叠加感染可能是该患者人群中临床和放射学偏差的重要原因，进一步恶化的临床结果和混淆的鉴别诊断。作为血栓形成，炎症，药物引起的并发症也可以引发COVID-19患者状态的急性改变，早期成像通常在区分患者下降的原因和监测患者预后中起着至关重要的作用。虽然COVID-19感染的常见放射学发现现在被广泛报道，对叠加感染的临床表现和影像学表现知之甚少。通过讨论开发细菌的患者的案例研究，真菌,寄生，和病毒共感染，并确定最常报告的叠加感染的影像学发现，医生将更熟悉常见的感染性表现，并更快地启动定向检查。最终,预期COVID-19成像表现的任何突然变化，例如存在新的固结或气蚀，应提示进一步检查以排除叠加的机会性感染。
