Laboratory findings in imaging diagnostic tests in patients infected with COVID-19 – A study review




COVID-19; Medical imaging; Computed tomography; X-ray; Thorax radiography.


Purpose: This study disseminates the diagnosis of COVID-19 emphasizing the importance of imaging tests in medical interpretation and identification of its complications, besides demonstrating the contribution to patient care. Methodology: The study was conducted based on a literature review, in addition to the acquired results of imaging tests from clinical patients at a Public Hospital of the State of Sergipe, Brazil, to point the scoring system in thorax radiography and compare to computed tomography (CT). Results: The imaging tests are not indicated for patients with mild symptoms and suspected COVID-19 infection, except for risk of disease progression, being indicated in the complementary diagnosis of COVID-19 positive patients. Studies show that thorax radiography is more used because it has low cost and easy access. However, its use has limitations due to the low sharpness of the images and impossibility of visualization of some lesions. Computed tomography, on the other hand, can be used as a pulmonary monitoring and evolution test in patients with COVID-19 worsening and/or persistent homeostatic changes. Nevertheless, this test is not indicated for acute cases without aggravating symptoms. Conclusion: The high degree of dissemination of SARS-CoV-2 and the collapse of health systems demonstrated the importance of the science in health. In addition, the importance of laboratory tests in the diagnosis of virus infection and imaging tests in the early diagnosis of SARS-CoV-2 pneumonia has been shown as efficient complementarity in the evolution and clinical interpretation of patients, highlighting the importance of radiography and CT exams.

Author Biographies

Caio Robert Rodrigues Martins de Souza, Tiradentes University

Biomedical Science student - Tiradentes University – UNIT, Avenida Murilo Dantas, 300 – Campus Farolândia, Aracaju, Sergipe, Brazil.

Danilo Lopes Santos, Tiradentes University

Biomedical Science student - Tiradentes University – UNIT, Avenida Murilo Dantas, 300 – Campus Farolândia, Aracaju, Sergipe, Brazil.

Larissa Maria Freire de Melo, Estácio Sergipe University Center

Biomedical Science student – Estácio Sergipe University Center – FASE, Rua Teixeira de Freitas, 10 – Salgado Filho, Aracaju, Sergipe Brazil.

Lumar Lucena Alves, Gerald Champion Regional Medical Center - GCRMC

Medical Laboratory Technician at Gerald Champion Regional Medical Center – GCRMC. 2669 N Scenic Drive, Alamogordo, New Mexico, USA.

Luiz André Santos Silva, Federal University of Sergipe

Postgraduate Program of Pharmaceutical Sciences (Ph.D) at Federal University of Sergipe – UFS. Av. Marechal Rondon, s/n, Jardim Roza Else, São Cristóvão, Sergipe, Brazil.

Natália Jamille Alves de Santana, Tiradentes University

Biomedical Science student - Tiradentes University – UNIT, Avenida Murilo Dantas, 300 – Campus Farolândia, Aracaju, Sergipe, Brazil.

Míriam Clécia de Oliveira Santos, Tiradentes University

Biomedical Science student - Tiradentes University – UNIT, Avenida Murilo Dantas, 300 – Campus Farolândia, Aracaju, Sergipe, Brazil.

Thatyane Gama Carvalho, Tiradentes University

Specialist in Computed Tomography and Magnetic, Technologist in Radiology - Tiradentes University – UNIT, Avenida Murilo Dantas, 300 – Campus Farolândia, Aracaju, Sergipe, Brazil.

Jonas Prata Estevão dos Santos, Tiradentes University

Technologist in Radiology, Teaching Specialist – Faculdade Faveni. Avenida Ângelo Altoé, 888, Venda Nova do Imigrante, Espírito Santo, Brazil.

Tereza Tizar Alves Oliveira, Tiradentes University

Bachelor Degree in Biomedical Science - Tiradentes University – UNIT, Avenida Murilo Dantas, 300 – Campus Farolândia, Aracaju, Sergipe, Brazil.

Ingridy Evangelista Viana Lucena, Tiradentes University

Master Degree in Industrial Biotechnology, Professor of Immunology/Specialist in Microbiology - Tiradentes University – UNIT. Avenida Murilo Dantas, 300 – Campus Farolândia, Aracaju, Sergipe, Brazil.

Raphaella Ingrid Santana Oliveira, Estácio Sergipe University Center

Master Degree in Industrial Biotechnology, Specialist in Hematology and Hemotherapy, Professor/Advisor - Estácio Sergipe University Center, Rua Teixeira de Freitas, 10 – Salgado Filho, Aracaju, Sergipe Brazil.


Araujo-Filho, J. A. B., Sawamura, M. V. Y., Costa, A. N., Cerri, G. G. & Nomura, C. H. (2020). Pneumonia por COVID-19: qual o papel da imagem no diagnóstico? Jornal Brasileiro de Pneumologia, 46(2).

Barone, M. T. U., Harnik, S. B., de Luca, P. V, Lima, B. L. S., Wieselberg, R. J. P., Ngongo, B., Pedrosa, H. C., Pimazoni-Netto, A., Franco, D. R., Souza, M. F. M., Malta, D. C. & Giampaoli, V. (2020). The impact of COVID-19 on people with diabetes in Brazil. Diabetes Research and Clinical Practice, 166, 108304. doi: 10.1016/j.diabres.2020.108304.

Baroni, R. H. (2003). Radiografia de tórax ou tomografia? Einsten, 1, 43-44.

Bertolazzi, P. & Melo, H. J. F. (2020). A importância da Tomografia Computadorizada no diagnóstico da COVID-19/The importance of Computed Tomography in diagnosis of COVID-19. Arquivos Médicos dos Hospitais e da Faculdade de Ciências Médicas da Santa Casa de São Paulo, 65:e11,1-4.

Borghesi A. & Maroldi, R. (2020a). COVID-19 outbreak in Italy: experimental chest X-ray scoring system for quantifying and monitoring disease progression. Radiol Med, 125(5), 509-513.

Borghesi, A., Zigliani, A., Masciullo, R., Golemi, S., Maculotti, P., Farina, D. & Maroldi, R. (2020b). Radiographic severity index in COVID-19 pneumonia: relationship to age and sex in 783 Italian patients. Radiol Med, 125(5), 461-464.

Casanova, J. L. & Su, H. C. (2020). COVID Human Genetic Effort, A Global Effort to Define the Human Genetics of Protective Immunity to SARS-CoV-2 Infection. Cell, 181(6), 1194-1199. doi: 10.1016/j.cell.2020.05.016.

Cellina, M., Orsi, M., Toluian, T., Valenti Pittino, C. & Oliva, G. (2020). False negative chest X-Rays in patients affected by COVID-19 pneumonia and corresponding chest CT findings. Radiography (Lond), 26(3), e189-e194. doi: 10.1016/j.radi.2020.04.017.

Chate, R. C. (2003). Radiografia de tórax: ainda é útil? Einsten, 1, 42-43.

Chen, T., Wu, D., Chen, H., Yan, W., Yang, D., Chen, G., Ma, K., Xu, D., Yu, h., Wang, H., Wang, T., Guo, W., Chen, J., Ding, C., Zhang, X., Huanf, J., Han, M., Li, S., Lu, X., Zhao, J. & Li, S. (2020). Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ, 368. doi:

Elicker, B., Pereira, C. A. C., Webb, R. & Leslie, K. O. (2008). Padrões tomográficos das doenças intersticiais pulmonares difusas com correlação clínica e patológica. J Bras pneumol., 34(9), 715-744.

Estevão, A. (2020). COVID -19. Acta Radiológica Portuguesa, 32(1), 5-6.

Foust, A. M., Phillips, G. S., Chu, W. C., Daltro, P., Das, K. M., Garcia-Peña, P., Kilbonr, T., Winant, A. J., & Lee, E. Y. (2020). International Expert Consensus Statement on Chest Imaging in Pediatric COVID-19 Patient Management: Imaging Findings, Imaging Study Reporting and Imaging Study Recommendations. Radiology: Cardiothoracic Imaging, 2(2), e200214.

Gordon, L., Nowik, P., Kesheh, S. M., Lidegran, M. & Diaz, S. (2020). Diagnosis of foreign body aspiration with ultralow-dose CT using a tin filter: a comparison study. Emerg Radio.l, 27(4), 399-404.

Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., Zhang, L., Fan, G., Xu, J., Gu, X., Cheng, Z., Yu, T., Xia, J., Wei, Y., Wu, W., Xie, X., Yin, W., Li, H., Liu, M., Xiao, Y., Gao, H., Guo, L., Xie, J., Wang, G., Jiang, R., gAO, z., jIN, q., Wang, J. & Cao, B. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet, 395(10223), 497-506. doi: 10.1016/S0140-6736(20)30183-5.

Huang, P., Liu, T., Huang, L., Liu, H., Lei, M., Xu, W., Chen, J. & Liu, Bo. (2020). Use of Chest CT in Combination with Negative RT-PCR Assay for the 2019 Novel Coronavirus but High Clinical Suspicion. Radiology. 295(1), 22-23. doi: 10.1148/radiol.2020200330.

Long, C., Xu, H., Shen, Q., Zhang, X., Fan, B., Wang, C., Zeng, B., Li, Z., Li, X. & Li, H. (2020). Diagnosis of the Coronavirus disease (COVID-19): RT-PCR or CT? Eur J Radiol, 126:108961. doi: 10.1016/j.ejrad.2020.108961

Neto, A. G. S., Santos, A. F., Santos, J. R., Alves, L. L., Ramos, A. C. S., Santana, A. A. F., Santos, I. D. D., Gaspar, L. M. A. C. (2021). COVID-19: Metodologias de diagnóstico. Research, Society and Development, 10(5).

Organização Pan-Americana de Saúde (Brasil) (OPAS/OMS) (2020). Folha informativa – COVID-19: (doença causada pelo novo coronavírus). 19&Itemid=875

Peck, K. R. (2020). Early diagnosis and rapid isolation: response to COVID-19 outbreak in Korea. Clinical Microbiology and Infection, 26(7), 805-807. doi: 10.1016/j.cmi.2020.04.025.

Prado, G. L. M. & Barjud, M.B. (2020). Radiologia em COVID 19: Fisiopatologia e aspectos da imagem nas diferentes fases clínicas da doença. Revista da FAESF, 4, 11-15. Retrieved from

Rubin, G. D., Ryerson, C. J., Haramati, L. B., Sverzellati, N., Kanne, J. P., Raoof, S., Schluger, N. W., Volpi, A., Yim, J-J., Martin, I. B. K., Anderson, D. J., Kong, C., Altes, T., Bush, A., Desai, S. R., Goldin, O., Goo, J. M., Humbert, M., Inouse, Y., Kauczor, H-U., Luo, F., Mazone, P. J., Prokop, M., Remy-Jardin, M., Richeldi, L., Schaefer-Prokop, C. M., Tomiyama, N., Wells, A. U. & Leung, A. N. (2020). The Role of Chest Imaging in Patient Management during the COVID-19 Pandemic: A Multinational Consensus Statement from the Fleischner Society. Radiology, 296(1), 172-180. doi: 10.1148/radiol.2020201365

Santos, M. L. O., Marchiori, E., Vianna, a. d., Souza Jr, A. S. & Moraes, H. P. (2003). Opacidades em vidro fosco nas doenças pulmonares difusas: correlação da tomografia computadorizada de alta resolução com a anatomopatologia. Radiol Bras., 36(6).

Shi, H., Han, X., Jiang, N, Cao, Y., Alwalid, O., Gu, J., Fan, Y. & Zheng, C. (2020). Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. The Lancet Infectious Diseases, 20(4), 425-434. DOI:

Souza Jr, A. S., Neto, C. A., Jasinovodolinsky, D., Marchiori, E., Kavakama, J., et al. (2002). Terminologia para a descrição de Tomografia Computadorizada do Tórax: Sugestões iniciais para um consenso brasileiro. Radiol Bras., 35(2), 125-128.

Toussie, A., Voutsinas, N., Finkelstein, M., Cedillo, M. A., Manna, S., Maron, S. Z., Jacobi., A., Chung, M., Bernheim, A., Eber, C., Concepcion, J., Fayad, Z. A. & Gupta, S. (2020). Clinical and Chest Radiography Features determine patient outcomes in young and middle-aged adults with COVID-19. Radiologia, 297(1), 201754.

Vardavas, C. I. & Nikitara, K. (2020). COVID-19 and smoking: A systematic review of the evidence. Tobacco Induced Diseases, 18:20. doi: 10.18332/tid/119324.

Wang, M., Cao, R., Zhang, L., Yang, X., Liu, J., Xu, M., Shi, Z., Hu, Z., Zhong, W. & Xiao, G. (2020). Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell research, 30, 269-271.

World Health Organization. (2020, January 9). WHO statement regarding cluster of pneumonia cases in Wuhan, China. Retrieved from

World Health Organization. (2020, May 8). Painel da Doença de Coronavírus da OMS (COVID-19). Retrieved from

Wu, D., Wu, T., Liu, Q. & Yang, Z. (2020). The SARS-CoV-2 outbreak: What we know. International Journal of Infectious Diseases, 94, 44-48. doi: 10.1016/j.ijid.2020.03.004.

Zhang, J-J., Dong, X., Cao, Y-Y., Yuan, Y-D., Yang, Y-B., Yan, Y-Q., Akdis, C. A. & Gao, Y-D. (2020). Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy, 75(7), 1730-1741. doi: 10.1111/all.14238.

Zheng, Z., Yao, Z., Wu, K. & Zheng, J. (2020). The diagnosis of pandemic coronavirus pneumonia: A review of radiology examination and laboratory test. Journal of Clinical Virology, (128), 104396. doi: 10.1016/j.jcv.2020.104396.

Zhou, F., Yu, T., Du, R., Fan, G., Liu, Y., Liu, Z., Xiang, J., Wang, Y., Song, B., Gu, X., Guan, L., Wei, Y., Li, H., Wu, X., Xu, J., Tu, S., Zhang, Y., Chen, H. & Cao, B. (2020). Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet, 395(10229), 1054-1062. doi: 10.1016/S0140-6736(20)30566-3.




How to Cite

SOUZA, C. R. R. M. de; SANTOS, D. L.; MELO, L. M. F. de; ALVES, L. L.; SILVA, L. A. S.; SANTANA, N. J. A. de; SANTOS, M. C. de O.; CARVALHO, T. G.; SANTOS, J. P. E. dos; OLIVEIRA, T. T. A.; LUCENA, I. E. V.; OLIVEIRA, R. I. S. Laboratory findings in imaging diagnostic tests in patients infected with COVID-19 – A study review. Research, Society and Development, [S. l.], v. 10, n. 6, p. e44110615936, 2021. DOI: 10.33448/rsd-v10i6.15936. Disponível em: Acesso em: 20 jun. 2021.



Review Article