Pendahuluan
SARS-CoV-2 merupakan virus RNA yang terutama menginfeksi sel-sel pada saluran napas pelapis alveoli. Virus SARS-CoV-2 yang terhirup mengikat sel epitel di rongga hidung dan mulai bereplikasi. Virus ini menyebar serta bermigrasi ke saluran pernapasan, memicu respons imun bawaan dan pada akhirnya berkembang menjadi Acute Respiratory Distress Syndrome (ARDS). Gambaran ground glass infiltrates dapat terdeteksi pada pencitraan toraks. Pemeriksaan X-ray toraks dan MSCT toraks memegang peranan penting dalam deteksi dan follow up COVID-19.
Metode dan Bahan
Laporan kasus 2 pasien laki-laki yang terkonfirmasi COVID-19 umur 43 tahun dan 48 tahun dengan keluhan utama sesak napas, batuk dan demam. Pasien pertama mempunyai riwayat perjalanan ke Amerika Serikat 3 minggu sebelum masuk rumah sakit, sedangkan pasien kedua mempunyai riwayat kontak dengan pasien terkonfirmasi COVID-19. Pada pemeriksaan X-ray toraks kedua pasien menunjukkan gambaran konsolidasi disertai air bronchogram pada lapangan paru bilateral yang tampak dominan pada perifer. Berdasarkan pedoman Severe Acute Respiratory Syndrome (SARS) terdahulu, evaluasi dapat dilakukan 2 bulan dan 6 bulan setelah terinfeksi. Dua bulan setelah terinfeksi COVID-19 dilakukan pemeriksaan HRCT toraks dengan hasil normal.
Kesimpulan
Lesi berupa konsolidasi disertai air bronchogram dengan distribusi yang dominan pada perifer merupakan gambaran radiologis yang khas pada pasien Covid-19 seperti yang ditemukan pada kedua kasus yang dipaparkan dalam artikel ini. Evaluasi sequele dengan pemeriksaan HRCT yang dilakukan 2 bulan pasca penyembuhan menunjukkan gambaran paru paru yang normal, tidak ada infiltrat maupun fibrosis pada kedua pasien tersebut.
Kata kunci
X-ray toraks, konsolidasi, air bronchogram, COVID-19
Introduction
SARS-CoV-2 is an RNA virus that mainly infects cells in the alveoli lining airways. The inhaled virus binds to epithelial cells in the nasal cavity then begins to replicate. This virus spreads, migrates to the respiratory tract, triggering an innate immune response, and develop to Acute Respiratory Syndrome. The ground-glass opacities can be detected in thoracic imaging eventually. Chest X-ray and CT-scan have an important role in the detection and follow-up of COVID-19.
Materials and Methods
The case report of 2 male patients confirmed COVID-19 aged 43 years and 48 years with major complaints of shortness of breath, coughing, and fever. The first patient had a history of raveling to the United States 3 weeks before hospitalization, while the second patient had a history of contact with a confirmed COVID-19 patient. On chest X-ray examination, both patients showed multiple consolidation with air bronchogram in bilateral lung field which appeared dominant in the periphery. According to the previous Severe Acute Respiratory Syndrome (SARS) guideline, evaluation for patients can be done in two months and six months after firstly infected. Two months after COVID-19 infection, a chest HRCT examination was performed with normal results.
Conclusion
Consolidation with air bronchogram which dominantly seen in peripheral distribution is a typical radiological picture in COVID-19 patients as found in two cases described in this article. Sequelae evaluation with chest HRCT conducted 2 months after healing showed normal lung appearance with no sign of infiltrates or fibrosis seen in both patients.
Keywords: Chest X-ray, consolidation, air bronchogram, COVID-19
Relation between the Lung Capacity, Oximetric Rebreath Test and Lung Field Area as Measured on the Chest X-ray Films in Three Phases of Respiration in Normal Subjects, the Aged and Patients with Chronic Pulmonary Emphysema