CT IMAGING FEATURES OF PATIENTS WITH COVID-19 AT A TERTIARY CARE HOSPITAL: EXPERIENCE FROM PAKISTAN

ABSTRACT

TOPIC Chest Infections TYPE Original Investigations PURPOSE: CT Chest is considered as one of the important modalities for the diagnosis and assessment of progression of COVID-19 disease. We conducted a study highlighting salient features of CT chest in patients with COVID-19 in a tertiary care center in Karachi, Pakistan. METHODS: This was a cross-sectional study done at Aga khan university from April 2020 to December 2020. Adult patients who had a positive COVID-19 PCR and underwent CT scan chest were included in the study. Five hundred and eighteen patients who underwent CT scan chest were selected for screening. One hundred and twelve patients who were positive for COVID-19 PCR were selected for review. Two patients were later excluded as they had chronic changes on CT scan due to underlying comorbidities. RESULTS: Among the study cohort of 110 patients, 70 (63.7 %) were males and 40 (36.4 %) were females with a mean age of 56.5 ± 14.8 years (range 46-67 years). Out of 110 patients, 79 underwent high-resolution CT (HRCT) scan and 31 underwent contrast-enhanced CT chest. The most common abnormality seen on CT was ground-glass opacities (79%), followed by consolidation (62%), crazy paving pattern (32%), vascular enlargement sign (27%) and fibrotic-like features or reticulations (21%). Furthermore, air bronchogram sign was seen in 21%, pleural effusion was seen in 8% and lymphadenopathy in 7% of patients. CONCLUSIONS: CT scan chest is a key tool of investigation in the diagnosis of COVID-19 disease. Studies from across the world have identified specific CT scan patterns that can aid in the diagnosis of the disease. This is a study from a low to middle-income country that describes the spectrum of radiological features found in COVID-19 and has also focused on certain atypical features associated with COVID-19. CLINICAL IMPLICATIONS Certain radiological features like ground-glass opacities and consolidation are a known features of COVID-19. This study emphasizes on the most frequent radiological features of COVID seen in a tertiary care hospital in Pakistan. Chest CT imaging has a high negative predictive value and high sensitivity for diagnosing COVID-19 and can be considered as an alternative primary screening tool for COVID-19 in epidemic areas. Moreover, a negative RT-PCR test and a positive CT chest finding can suggest COVID-19. Hence as a clinician and radiologist, one should be aware of all the spectrum of radiological features so that early diagnosis and management can be facilitated. DISCLOSURES No relevant relationships by Safia Awan, source=Web Response No relevant relationships by Kulsoom Fatima, source=Web Response no disclosure on file for Basit Salam;No relevant relationships by Aqusa Zahid, source=Web Response No relevant relationships by Syed Muhammad Zubair, source=Web Response No relevant relationships by Ali Zubairi, source=Web Response