Rapid onset of bronchiectasis in COVID-19 Pneumonia: two cases studied with CT

Maria Chiara Ambrosetti, Giulia Battocchio, Giulia Angela Zamboni, Cristiano Fava, Evelina Tacconelli, Giancarlo Mansueto.

Radiol Case Rep . 2020 Nov;15(11):2098-2103. doi: 10.1016/j.radcr.2020.08.008., 11/2020.

Since the widespread of acute respiratory syndrome infection caused by  Coronavirus-19 unenhanced computed tomography (CT) was considered an  useful imaging tool commonly used in early diagnosis and monitoring of  patients with complicated COVID-19 pneumonia. Many typical imaging  features of this disease were described such as bilateral multilobar  ground-glass opacification (GGO) with a prevalent peripheral or  posterior distribution, mainly in the lower lobes, and sometimes  consolidative opacities superimposed on GGO. As less common findings  were mentioned septal thickening, bronchiectasis, pleural thickening,  and subpleural involvement. After 3 months from the onset of COVID-19  pneumonia some studies published the evolution of imaging features of  COVID-19 pneumonia such as an increase of GGOs and a progressive  transformation of GGO into multifocal consolidative opacities, septal  thickening, and development of a crazy-paving pattern. As far as we know  bronchiectasis were described only as a possible aspecific imaging  feature of COVID-19 pneumonia and no studies reporting the onset or  evolution of bronchiectasis during imaging follow-up in patients with  COVID-19 have been published. Here we describe two cases of rapid  evolution of bronchiectasis documented at CT in patients with COVID-19  pneumonia. Further studies are necessary to determine predisposing  factors to the onset of bronchiectasis and to evaluate clinical  correlation with respiratory distress. Radiologists should always  consider bronchial features when they report CT scans of patients with  COVID-19 pneumonia.