Clarifying Terminology of Signs in COVID-19


Yale S. H. , TEKİNER H. , GÖRKEM S. B. , Draves J., Ye F., Yale E. S.

ERCIYES MEDICAL JOURNAL, vol.43, no.6, pp.530-536, 2021 (Journal Indexed in ESCI) identifier

  • Publication Type: Article / Review
  • Volume: 43 Issue: 6
  • Publication Date: 2021
  • Doi Number: 10.14744/etd.2021.33716
  • Title of Journal : ERCIYES MEDICAL JOURNAL
  • Page Numbers: pp.530-536
  • Keywords: COVID-19, radiology, pulmonary complications, signs, terminology, DISEASE 2019 COVID-19, CORONAVIRUS DISEASE, HALO SIGN, CHEST CT, DIAGNOSTIC-VALUE, REVERSED HALO, PNEUMONIA, MANIFESTATIONS, FEATURES

Abstract

The term "sign" has been used to describe various phenomena observed in patients with coronavirus disease 2019 (COVID-19). Discrepancies in the use of this term have been identified when it is used in context with COVID-19. The goals of this review are to provide an overview, describe signs, and clarify misconceptions regarding the use of these terms in COVID-19 patients. PubMed and Medline databases were searched using individual and Medical Subject Headings (MeSH) terms, including coronavirus, COVID-19, and sign, in human studies within the English literature published from inception to December 31, 2020. Studies where the word "sign" was used in a context different from that for COVID-19 (e.g., sentinel sign) were excluded. Three hundred fifty-seven studies were potentially identified and after applying the exclusion criteria and further adjudication, 92 studies constituted the final data set. The majority of signs found in the COVID-19 literature have been applied and aptly described primarily in radiologic diseases of the chest. The term "sign," in other situations, is often misappropriated as it actually represents a physical finding rather than a sign. A total of 27 radiologic signs have been identified on chest computed tomography (CT) or high-resolution CT (HRCT), and 18 cutaneous signs (or findings) have been observed during the physical examination in COVID-19. Signs lack sufficient sensitivity or specificity by themselves; however, in the appropriate clinical setting, they should raise clinical suspicion for this infectious disease.