Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is a marked increase in hazy bilateral opacification with a predominantly central distribution , most consistent with pulmonary edema . Effacement of the left costophrenic sulcus may be due to a small pleural effusion . The cardiac , mediastinal , and hilar contours appear unchanged .
    OUTPUT:
    
Findings consistent with moderate - to - severe pulmonary edema , increased since the prior study .