VARIATIONS IN SPECTRUM OF COVID-19 CT FINDINGS AND ITS SEVERITY SCORING IN A TERTIARY CARE HOSPITAL OF BAHAWALPUR, SOUTHERN PUNJAB PAKISTAN

Authors

  • Sarah Nisar Khan Bahawal Victoria hospital /Quaid.E.Azam medical college .Bahawalpur.
  • Lubna Sarfraz Quaid.E.Azam medical college .Bahawalpur.
  • Fariha mumtaz Bahawal Victoria hospital. Bahawalpur
  • Khaula sidra Bahawal Victoria hospital .Bahawalpur

Abstract

Background: Recently the Coronavirus pandemic presented with different manifestations in different parts of the world, both on clinical examinations and on imaging. CT Scanning (CT Scan) chest is used for detailed evaluation of the different characteristic patterns determining the depth of disease. The study is aimed to assess the variations in spectrum of Covid-19 CT findings and relating severity (CT Severity Score) with the Clinical Symptoms in Bahawal Victoria Hospital, Bahawalpur. Methods: In this cross-sectional study, patients referred to radiology department from outdoor for COVID screening were included from 1st May to 30th June 2020. Mean age range of patients was calculated, while presenting complaints and co-morbidities were tabulated in frequencies and percentages after analysis. Severity of symptoms and CT findings were correlated with biochemical and haematological tests. Results: Patients’ age range from 25 to 85 years with 62% males and 38% females. Statistically no significant difference was observed in CTSS on gender basis. As sensitivity of RT PCR is about 70%, negative cases cannot be considered disease free and this is seen in this study as CT findings suggestive of COVID are seen in these patients. Using 40-point CT-SS, 11 patients had a score of >19 with severe diseases, while 14 patients had common disease with a score range of 11–18 and 35 patients had <10 score with mild or no symptoms. Conclusion: In this study, a spectrum of patchy ground glass opacities, bilateral peripheral predominantly lower lung consolidations were observed. Quantitative analysis of inflammatory process as occurring in lungs in Coronavirus Disease 2019, using 40-point CTSS scoring on Imaging could provide a timely and objective approach towards identifying patients requiring intensive care and hospitalisation. Keywords: COVID-19; Corona virus; CTSS (CT Severity Score); Ground-glass opacity

Author Biographies

Sarah Nisar Khan, Bahawal Victoria hospital /Quaid.E.Azam medical college .Bahawalpur.

Fellow of College of Physicians and Surgeons Pakistan,(2014) in Diagnostic Radiology (FCPS)working as Assistant Professor of Radiology in Bahawal Victoria Hospital/Quaid- e –Azam Medical College, Bahawalpur, Pakistan since  March 2014,Supervisor of FCPS and MD Radiology Training program .

Lubna Sarfraz, Quaid.E.Azam medical college .Bahawalpur.

FCPS, Chemical Pathology working as  Associate Professor, Pathology Department,  Quaid-e-Azam Medical College. Bahawalpur

Fariha mumtaz, Bahawal Victoria hospital. Bahawalpur

FCPS, Radiology working as   senior registrar, Bahawal Victoria hospital. Bahawalpur

Khaula sidra, Bahawal Victoria hospital .Bahawalpur

Post graduate Resident of Radiology at Bahawal Victoria hospital. Bahawalpur

References

REFERENCES

Yang R, Li X, Liu H, Zhen Y, Zhang X, Xiong Q, et al. Chest CT Severity Score: An Imaging Tool for Assessing Severe COVID-19. Radiol Cardiothorac Imaging [Internet]. 2020 Apr 1 [cited 2020 Jul 15];2(2):e200047. Available from: http://pubs.rsna.org/doi/10.1148/ryct.2020200047

Durrani M, Haq IU, Kalsoom U, Yousaf A. Chest X-rays findings in COVID 19 patients at a University Teaching Hospital - A descriptive study. Pak J Med Sci [Internet]. 2020 May 9 [cited 2020 Jul 15];36(COVID19-S4). Available from: http://www.pjms.org.pk/index.php/pjms/article/view/2778

Fu F, Lou J, Xi D, Bai Y, Ma G, Zhao B, et al. Chest computed tomography findings of coronavirus disease 2019 (COVID-19) pneumonia. Eur Radiol [Internet]. 2020 May 20 [cited 2020 Jul 15]; Available from: http://link.springer.com/10.1007/s00330-020-06920-8

Parry AH, Wani AH, Yaseen M, Dar KA, Choh NA, Khan NA, et al. Spectrum of chest computed tomographic (CT) findings in coronavirus disease-19 (COVID-19) patients in India. Eur J Radiol [Internet]. 2020 Aug [cited 2020 Jul 15];129:109147. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0720048X20303363

Shi H, Han X, Jiang N, Cao Y, Alwalid O, Gu J, et al. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect Dis [Internet]. 2020 Apr [cited 2020 Jul 15];20(4):425–34. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1473309920300864

Lanza E, Muglia R, Bolengo I, Santonocito OG, Lisi C, Angelotti G, et al. Quantitative chest CT analysis in COVID-19 to predict the need for oxygenation support and intubation. Eur Radiol [Internet]. 2020 Jun 26 [cited 2020 Jul 15]; Available from: http://link.springer.com/10.1007/s00330-020-07013-2

Shahzeb M, Khan A, Muhammad A. 3 Role of Imaging Technology and current status. 2020;53:5.

Chen HJ, Qiu J, Wu B, Huang T, Gao Y, Wang ZP, et al. Early chest CT features of patients with 2019 novel coronavirus (COVID-19) pneumonia: relationship to diagnosis and prognosis. Eur Radiol [Internet]. 2020 Jun 9 [cited 2020 Jul 15]; Available from: http://link.springer.com/10.1007/s00330-020-06978-4

Fang X, Li X, Bian Y, Ji X, Lu J. Relationship between clinical types and radiological subgroups defined by latent class analysis in 2019 novel coronavirus pneumonia caused by SARS-CoV-2. Eur Radiol [Internet]. 2020 May 30 [cited 2020 Jul 15]; Available from: http://link.springer.com/10.1007/s00330-020-06973-9

Li Y, Yang Z, Ai T, Wu S, Xia L. Association of “initial CT” findings with mortality in older patients with coronavirus disease 2019 (COVID-19). Eur Radiol [Internet]. 2020 Jun 10 [cited 2020 Jul 15]; Available from: http://link.springer.com/10.1007/s00330-020-06969-5

Meng H, Xiong R, He R, Lin W, Hao B, Zhang L, et al. CT imaging and clinical course of asymptomatic cases with COVID-19 pneumonia at admission in Wuhan, China. J Infect [Internet]. 2020 Jul [cited 2020 Jul 15];81(1):e33–9. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0163445320302115

Inui S, Fujikawa A, Jitsu M, Kunishima N, Watanabe S, Suzuki Y, et al. Chest CT Findings in Cases from the Cruise Ship “Diamond Princess” with Coronavirus Disease 2019 (COVID-19). Radiol Cardiothorac Imaging [Internet]. 2020 Apr 1 [cited 2020 Jul 15];2(2):e200110. Available from: http://pubs.rsna.org/doi/10.1148/ryct.2020200110

Wang Y-C, Luo H, Liu S, Huang S, Zhou Z, Yu Q, et al. Dynamic evolution of COVID-19 on chest computed tomography: experience from Jiangsu Province of China. Eur Radiol [Internet]. 2020 Jun 10 [cited 2020 Jul 15]; Available from: http://link.springer.com/10.1007/s00330-020-06976-6

Bernheim A, Mei X, Huang M, Yang Y, Fayad ZA, Zhang N, et al. Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Duration of Infection. Radiology [Internet]. 2020 Jun 1 [cited 2020 Jul 15];295(3):200463. Available from: http://pubs.rsna.org/doi/10.1148/radiol.2020200463

Rodrigues JCL, Hare SS, Edey A, Devaraj A, Jacob J, Johnstone A, et al. An update on COVID-19 for the radiologist - A British society of Thoracic Imaging statement. Clin Radiol [Internet]. 2020 May [cited 2020 Jul 15];75(5):323–5. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0009926020300878

Simpson S, Kay FU, Abbara S, Bhalla S, Chung JH, Chung M, et al. Radiological Society of North America Expert Consensus Statement on Reporting Chest CT Findings Related to COVID-19. Endorsed by the Society of Thoracic Radiology, the American College of Radiology, and RSNA. Radiol Cardiothorac Imaging [Internet]. 2020 Apr 1 [cited 2020 Jul 15];2(2):e200152. Available from: http://pubs.rsna.org/doi/10.1148/ryct.2020200152

Li Y, Xia L. Coronavirus Disease 2019 (COVID-19): Role of Chest CT in Diagnosis and Management. Am J Roentgenol [Internet]. 2020 Jun [cited 2020 Jul 15];214(6):1280–6. Available from: https://www.ajronline.org/doi/10.2214/AJR.20.22954

Zhao W, Zhong Z, Xie X, Yu Q, Liu J. Relation Between Chest CT Findings and Clinical Conditions of Coronavirus Disease (COVID-19) Pneumonia: A Multicenter Study. Am J Roentgenol [Internet]. 2020 May [cited 2020 Jul 15];214(5):1072–7. Available from: https://www.ajronline.org/doi/10.2214/AJR.20.22976

Xiong Y, Sun D, Liu Y, Fan Y, Zhao L, Li X, et al. Clinical and High-Resolution CT Features of the COVID-19 Infection: Comparison of the Initial and Follow-up Changes. Invest Radiol [Internet]. 2020 Jun [cited 2020 Jul 15];55(6):332–9. Available from: http://journals.lww.com/10.1097/RLI.0000000000000674

Prokop M, van Everdingen W, van Rees Vellinga T, Quarles van Ufford H, Stöger L, Beenen L, et al. CO-RADS: A Categorical CT Assessment Scheme for Patients Suspected of Having COVID-19—Definition and Evaluation. Radiology [Internet]. 2020 Aug [cited 2020 Jul 24];296(2):E97–104. Available from: http://pubs.rsna.org/doi/10.1148/radiol.2020201473

Downloads

Published

2021-02-20