Role of 'Radiological Phenotypes' in Diagnosis, Treatment and Assessment of Covid-19 Pneumonia: Multicentric study of 6000 cases in tertiary care setting in India

Methods: multicentric observational study, included 6000 COVID-19 RT PCR Positive cases with lung involvement on HRCT thorax at entry point & categorised as Radiological presentation phenotypes as severity assessmentmild, moderate, severe as per lung segment involvement (mild<7, moderate 8-15 and severe 16-25), Evolving and Evolved phenotype- with or without GGOs, consolidations, and crazy paving with or without spreading edges, Anatomical phenotype-Unilateral or bilateral as per lung lobe segment or lobe involvement, Clinicalradiological-pathological phenotypes-five types as classical GGOs, consolidations, Bronchopneumonia, Necrotizing pneumonia and cavitating. Response to treatment phenotypes-easy to treat and difficult to treat as per interventions required & response to treatment. Radiological outcome phenotypes as Resolving, Persistent and Progressive as per lung reticular and fibrosing lesions as with or without honeycombing and or tractional bronchiectasis. Statistical analysis by Chi test and students t test and ANOVA. Observations and analysis:In 6000 radiological assessment of covid-19 pneumonia, significant association was documented in Evolving and Evolved pneumonia phenotypes (p<0.000026), Unilateral and Bilateral pneumonia anatomical phenotypes (p<0.00001), Clinical-radiological-pathological phenotypes (p<0.00001), Easy to treat and Difficult to treat pneumonia phenotypes (p<0.00001), Radiological final outcome phenotypes-Persistent, Progressive & Resolving phenotype (p<0.00001) conclusion: Radiological phenotypes will guide in assessing severity, predicting response to therapy and final outcome in covid-19 pneumonia.

'Long covid' is more common, underestimated, and 'core' health issue in post covid care setting: study of 6000 cases in tertiary care setting in India

Methods: observational study, included 6000 COVID-19 indoor cases confirmed with RT-PCR. Retrospective analysis with treatment records, laboratory markers as IL-6, D-dimer, Ferritin, LDH, BSL, HBA1C. All cases undergone thorough interview in 'post covid care' outdoor setting regarding symptomatology, documnted vital signs abnormality, & workup as HBA1C, BSL, TFT, KFT, ECG, chest x-ray, HRCT thorax, BMD, Echocardiography, MRI brain whichever is necessary. Statistical analysis by using Chi square test and ANOVA. Observations: Long covid manifestations were documented in 36.06% (2517/6000) post COVID cases as- Fatigue 41.95%, dyspnea 35.98%, cough 31.96%, chest discomfort 26.95%, anosmia 8.76%, joint pain & headache 11.96% , dizziness, vertigo&insomnia 22.95% &alopecia 4.18% cases, Lung fibrosis in 16.66%, minimal lung abnormality 23.65%, pulmonary embolism 7.18% cases, palpitations 25.56%, chest pain 11.3%, arrythmias 5.53%, cardiac dysfunction 24.31%, PTSD 28%, Impaired memory with or without poor concentration (brain fog) 24.03%, Anxiety and or depression 6.33%, Reduction in quality of life 33%, Diabetes mellitus-new onset26%, transient34%, uncontrolled27%, Osteoporosis38.08%, thyroid dysfunction12.1%. CT severity score, Intensive care treatment with or without oxygen and or ventilator use & Laboratory parameters (D-dimer, IL6, LDH, Ferritin) during hospitalization has significant association with long covid manifestations (p<0.00001) Conclusion(s): Long covid in underestimated, improperly evaluated and halfheartedly treated during follow-up. All treated cases needs prompt evaluation, more awareness regrding its manifestations and its impact on quality of life is must.