ABSTRACT
Corona virus disease 2019(COVID-19) caused by novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global pandemic in short time. Computed tomography (CT) of the chest can help in diagnosis, staging of the disease and various imaging manifestations of the disease on CT have been extensively reported in the literature but Indian studies are relatively little. In this pictorial review we would like to highlight the common and uncommon CT manifestations of COVID-19 disease.
ABSTRACT
Corona virus disease-19 (COVID-19) usually causes multifocal bilateral peripheral ground glass opacities and patchy consolidations in subpleural location predominantly involving lower lobe and posterior segments on computed tomography (CT). Here, we present a rare mode of presentation of COVID 19 with spontaneous pneumomediastinum and spontaneous pneumothorax on CT. Only few cases of spontaneous pnuemomediastinum and pneumothorax have been reported in COVID-19 pneumonitis. This case highlights the role of CT in the early diagnosis of pneumomediastinum and pneumothorax in patients with COVID-19 Pneumonitis.
ABSTRACT
Objective: To characterize the clinical features, laboratory and CT findings of 50 RT-PCR proven patients with COVID19. Materials and methods: A retrospective study of 50 patients with RT-PCR confirmed COVID-19 was performed. CT images were reviewed by two experienced radiologists. Clinical data was also recorded. he percentage of each CT findings was evaluated. Patients were divided into early and advanced phase depending on symptom onset which is less than or equal to 7 days and 7 to 14 days. Chi-square test was used to compare the CT features of early and advanced phase of COVID-19 pneumonitis. Results: There were totally 50 patients included in the study and among them 33 patients were male and 17 were female. The age group ranged from 22 to 87 years with median age of 48 years. There were 26 patients who underwent CT in early stage and 24 patients in advanced stage. Most of the patients presented with fever and cough with lymphocytopenia and elevated CRP being the most common lab finding. The most common finding in CT scan was ground glass opacities which was seen in 41(82%) patients. GGO with consolidation was seen in 20(40%) patients and GGO with interstitial thickening or crazy paving was seen in 10(20%) patients. Air bubble sign was seen in 2 (4%) patients. Vascular dilatation was seen in 9(18%) patients. Subpleural fibrotic bands, architectural distortion were seen in 8(16%) patients. Subpleural line and halo sign was seen in 2(4%) patients. Nodules were seen in 1 (2%) patient. Air bronchogram within the consolidation was seen in 8(16%) patients. Bronchial dilatation and distortion was seen in 4 (8%) patients. Pleural thickening (18%) was common than pleural effusion (8%). Mediastinal lymphadenopathy and pericardial effusion were seen in 4% cases. In the early phase, GGO were more common and was seen in all 26 patients in early phase. Consolidation, air bronchogram, bronchial abnormalities and pleural effusion were more common in the advanced phases and was statistically significant. Rest of the other parameters did not show any statistical significance. The sensitivity of CT in diagnosing COVID-19 pneumonia was 96.15% in early phase and 83.33% in advanced phase and 90% overall. Conclusion: Fever and cough were the most common clinical finding. Elevated CRP and lymphocytopenia were the most common lab finding. Multifocal GGO with peripheral, posterior, lower lobe and bilateral involvement was the mostcommon imaging finding. CT can stage the disease as GGO was common in early phase and consolidation in later phases. CT is indicated in patients with moderate to severe symptoms and in RT-PCR negative cases with symptoms suggestive of COVID-19.