Mediastinal Adenopathy After COVID-19 Infection

Main Article Content

Kaveer Greywal Nelson Greene Rahul Kashyap Salim Surani, MD, MPH, MSHM, FACP, FAASM, FCCP


Since the outbreak of the COVID-19 pandemic, there have been myriad signs and symptoms ascribed to this disease process. While some of the most notable features described since the initial months of the pandemic include cough, fever, myalgia, headache, dyspnea/hypoxia, anosmia, and multifocal pneumonia, the pandemic’s prolonged continuation has afforded ample opportunity to detect more subtle signs of the disease. Mediastinal adenopathy is one such sign that has been found in many patients with active COVID-19 infection, though the value of this finding in both prognostication and guiding treatment remains unknown. We did a timely brief review of mediastinal adenopathy in COVID-19 infection to shed more light on the potential implications of this finding. We conclude that Mediastinal Adenopathy in hospitalized COVID-19 patients has been associated with higher ICU admissions and higher mortality. Its non-specific nature and confounding etiology may prevent it from being a good marker for prognosticator of COVID-19 disease severity.

Keywords: COVID-19, New-Onset Atrial Fibrillation, NOAF, ACE2, Hypoxia

Article Details

How to Cite
GREYWAL, Kaveer et al. Mediastinal Adenopathy After COVID-19 Infection. Medical Research Archives, [S.l.], v. 10, n. 3, mar. 2022. ISSN 2375-1924. Available at: <>. Date accessed: 25 june 2024. doi:
Review Articles


[1] Taweesedt PT, Surani S. Mediastinal lymphadenopathy in COVID-19: A review of literature. WJCC. 2021;9(12):2703-2710. doi:10.12998/wjcc.v9.i12.2703
[2] Nin CS, de Souza VVS, do Amaral RH, et al. Thoracic lymphadenopathy in benign diseases: A state of the art review. Respiratory Medicine. 2016;112:10-17. doi:10.1016/j.rmed.2016.01.021
[3] Ganeshalingam S, Koh DM. Nodal staging. Cancer Imaging. 2009;9(1). doi:10.1102/1470-7330.2009.0017
[4] Sardanelli F, Cozzi A, Monfardini L, et al. Association of mediastinal lymphadenopathy with COVID-19 prognosis. The Lancet Infectious Diseases. 2020;20(11):1230-1231. doi:10.1016/S1473-3099(20)30521-1
[5] Meyer HJ, Wienke A, Surov A. Extrapulmonary CT Findings Predict In-Hospital Mortality in COVID-19. A Systematic Review and Meta-Analysis. Academic Radiology. 2022;29(1):17-30. doi:10.1016/j.acra.2021.10.001
[6] Satici C, Cengel F, Gurkan O, Demirkol MA, Altunok ES, Esatoglu SN. Mediastinal lymphadenopathy may predict 30-day mortality in patients with COVID-19. Clinical Imaging. 2021;75:119-124. doi:10.1016/j.clinimag.2021.01.028
[7] Pilechian S, Pirsalehi A, Arabkoohi A. Mediastinal lymphadenopathy and prognosis of COVID-19 disease. IJM. Published online August 16, 2021. doi:10.18502/ijm.v13i4.6974
[8] Kassem MNE, Masallat DT. Clinical Application of Chest Computed Tomography (CT) in Detection and Characterization of Coronavirus (Covid-19) Pneumonia in Adults. J Digit Imaging. 2021;34(2):273-283. doi:10.1007/s10278-021-00426-5
[9] Li X, Fang X, Bian Y, Lu J. Comparison of chest CT findings between COVID-19 pneumonia and other types of viral pneumonia: a two-center retrospective study. Eur Radiol. 2020;30(10):5470-5478. doi:10.1007/s00330-020-06925-3
[10] Zheng Q, Lu Y, Lure F, Jaeger S, Lu P. Clinical and radiological features of novel coronavirus pneumonia. XST. 2020;28(3):391-404. doi:10.3233/XST-200687
[11] Bai HX, Hsieh B, Xiong Z, et al. Performance of Radiologists in Differentiating COVID-19 from Non-COVID-19 Viral Pneumonia at Chest CT. Radiology. 2020;296(2):E46-E54. doi:10.1148/radiol.2020200823
[12] Salehi S, Abedi A, Balakrishnan S, Gholamrezanezhad A. Coronavirus Disease 2019 (COVID-19): A Systematic Review of Imaging Findings in 919 Patients. American Journal of Roentgenology. 2020;215(1):87-93. doi:10.2214/AJR.20.23034
[13] Silva M, Ledda RE, Schiebler M, et al. Frequency and characterization of ancillary chest CT findings in COVID-19 pneumonia. BJR. 2021;94(1118):20200716. doi:10.1259/bjr.20200716
[14] Scarlattei M, Baldari G, Silva M, et al. Unknown SARS-CoV-2 pneumonia detected by PET/CT in patients with cancer. Tumori. 2020;106(4):325-332. doi:10.1177/0300891620935983
[15] Jin C, Luo X, Qian S, et al. Positron emission tomography in the COVID-19 pandemic era. Eur J Nucl Med Mol Imaging. 2021;48(12):3903-3917. doi:10.1007/s00259-021-05347-7
[16] Iyer H, Anand A, Sryma P, et al. Mediastinal lymphadenopathy: a practical approach. Expert Review of Respiratory Medicine. 2021;15(10):1317-1334. doi:10.1080/17476348.2021.1920404
[17] Bao C, Liu X, Zhang H, Li Y, Liu J. Coronavirus Disease 2019 (COVID-19) CT Findings: A Systematic Review and Meta-analysis. Journal of the American College of Radiology. 2020;17(6):701-709. doi:10.1016/j.jacr.2020.03.006
[18] Valette X, du Cheyron D, Goursaud S. Mediastinal lymphadenopathy in patients with severe COVID-19. The Lancet Infectious Diseases. 2020;20(11):1230. doi:10.1016/S1473-3099(20)30310-8 1.
[19] Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet. 2020;395(10223):497-506. doi:10.1016/S0140-6736(20)30183-5 1.
[20] Caruso D, Zerunian M, Polici M, et al. Chest CT Features of COVID-19 in Rome, Italy. Radiology. 2020;296(2):E79-E85. doi:10.1148/radiol.2020201237 1.
[21] Walkey AJ, Sheldrick RC, Kashyap R, et al. Guiding Principles for the Conduct of Observational Critical Care Research for Coronavirus Disease 2019 Pandemics and Beyond: The Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study Registry. Critical Care Medicine. 2020;48(11):e1038-e1044. doi:10.1097/CCM.0000000000004572
[22] Walkey AJ, Kumar VK, Harhay MO, et al. The Viral Infection and Respiratory Illness Universal Study (VIRUS): An International Registry of Coronavirus 2019-Related Critical Illness. Critical Care Explorations. 2020;2(4):e0113. doi:10.1097/CCE.0000000000000113