COVID-19 mimics on chest CT: a pictorial review and radiologic guide

Br J Radiol. 2021 Feb 1;94(1118):20200703. doi: 10.1259/bjr.20200703. Epub 2020 Dec 9.


Chest imaging is often used as a complementary tool in the evaluation of coronavirus disease 2019 (COVID-19) patients, helping physicians to augment their clinical suspicion. Despite not being diagnostic for COVID-19, chest CT may help clinicians to isolate high suspicion patients with suggestive imaging findings. However, COVID-19 findings on CT are also common to other pulmonary infections and non-infectious diseases, and radiologists and point-of-care physicians should be aware of possible mimickers. This state-of-the-art review goal is to summarize and illustrate possible etiologies that may have a similar pattern on chest CT as COVID-19. The review encompasses both infectious etiologies, such as non-COVID viral pneumonia, Mycoplasma pneumoniae, Pneumocystis jiroveci, and pulmonary granulomatous infectious, and non-infectious disorders, such as pulmonary embolism, fat embolism, cryptogenic organizing pneumonia, non-specific interstitial pneumonia, desquamative interstitial pneumonia, and acute and chronic eosinophilic pneumonia.

Publication types

  • Systematic Review

MeSH terms

  • Adult
  • Aged
  • COVID-19 / diagnostic imaging*
  • Community-Acquired Infections / diagnostic imaging
  • Diagnosis, Differential
  • Embolism, Fat / diagnostic imaging
  • Female
  • Granulomatous Disease, Chronic / diagnostic imaging
  • Humans
  • Lung Diseases / diagnostic imaging
  • Lung Diseases, Interstitial / diagnostic imaging
  • Male
  • Middle Aged
  • Pneumonia, Mycoplasma / diagnostic imaging
  • Pneumonia, Pneumocystis / diagnostic imaging
  • Pneumonia, Viral / diagnostic imaging
  • Pulmonary Embolism / diagnostic imaging
  • Pulmonary Eosinophilia / diagnostic imaging
  • Radiography, Thoracic / methods
  • Time Factors
  • Tomography, X-Ray Computed / methods*