Der Radiologe
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Neurologic, pulmonary, cardiac and gastrointestinal functional disorders can persist in the post-acute phase and constitute a long COVID syndrome, also known as post-acute sequelae of SARS-CoV‑2 infection (PASC). Some patients develop persistent and debilitating symptoms despite a relatively mild illness at onset and they are known as COVID-19 long haulers. ⋯ Given that COVID-19 is a new disease, it is not possible to determine how long these effects will last. Long-term monitoring of post-acute COVID-19 symptoms and screening for frequent comorbid conditions are essential.
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Vaccine-induced cerebral venous and sinus thrombosis (VI-CVST) is a rare complication in recipients of the adenovirus-vectored coronavirus disease 2019 (COVID-19) vaccine ChAdOx1 nCov-19 (Vaxzevria®; AstraZeneca). ⋯ The clinical suspicion of VI-CVST calls for urgent laboratory and neuroimaging workup. In the presence of thrombocytopenia and/or pathogenic antibodies, specific medications for anticoagulation and immunomodulation are recommended.
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Artificial intelligence (AI) has the potential to fundamentally change medicine within the coming decades. Radiological imaging is one of the primary fields of its clinical application. ⋯ The clinical use of AI applications is still in an early stage of development. The large number of research publications shows the potential of the field. Several certified products have already become available to users. However, for a widespread adoption of AI applications in clinical routine, several fundamental prerequisites are still awaited. These include the generation of evidence justifying the use of algorithms through representative clinical studies, adjustments to the framework for approval processes and dedicated education and teaching resources for its users. It is expected that use of AI methods will increase, thus, creating new opportunities for improved diagnostics, therapy, and more efficient workflows.
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Clinically, coronavirus disease 2019 (COVID-19) is associated with a wide range of symptoms, which can range from mild complaints of an upper respiratory infection to life-threatening hypoxic respiratory insufficiency and multiorgan failure. ⋯ In addition to microvascular thrombosis, our results indicate a functional pulmonary vasodysregulation as part of the pathophysiology during the vascular phase of COVID-19. The clinical relevance of autopsies and the integration of radiological imaging findings into histopathological injury patterns must be emphasized for a better understanding of COVID-19.
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Point-of-care ultrasound (POCUS) of the lung in patients with COVID-19 plays a key role in the emergency room and intensive care unit. Lung ultrasound is able to depict typical pulmonary findings of COVID-19 and is therefore suitable for diagnosis and follow-up of these patients. ⋯ Lung ultrasound in patients with COVID-19 offers similar performance as CT and is superior when compared to X‑ray in evaluating pneumonia and acute respiratory distress syndrome (ARDS). Lung ultrasound plays an important role in the emergency room and intensive care unit. POCUS reduces exposure to radiation, therapy delays, and minimizes transport of high-risk patients. Differential diagnoses can also be clarified.