Mediastinal lymphadenopathy in patients with severe COVID-19

22 Apr, 2020

CT has a leading place in the management of patients with coronavirus disease 2019 (COVID-19). Mediastinal lymph node enlargement is not considered a typical CT feature of COVID-19, and only 6% of patients admitted to hospital for COVID-19 had lymphadenopathy. This observation is concordant with previous studies in Chinese populations. However, the experience in critically ill patients with COVID-19 in France seems to be different.

Lymphadenopathy was more common in French cohort of ICU patients than previously reported. Even this symptom had not been described in COVID-19 patients before, most reports were not specifically concerning critically ill patients, so disease severity could probably explain this discrepancy, as suggested by Li and colleagues. Further studies are needed to better characterize the CT features of patients with COVID-19, in order to establish a possible link between the presence of specific radiological signs and the severity of the disease. Pending such studies, lymphadenopathy should not be considered an atypical feature of COVID-19, especially when we have seen that mediastinal lymph nodes are very large in our critically ill patients.

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