Typical and atypical chest CT findings in COVID-19 RTPCR positive patients

ABSTRACT

Introduction:COVID-19 usually manifests clinically as pneumonia with predominant imaging findings of an atypical or organizing pneumonia. The standard technique for confirming COVID-19 is molecular testing by RT-PCR however chest imaging by CT scan can show signs of pneumonia in patients with negative RT-PCR and results can be achieved significantly faster, thus offering a potential role in supporting rapid decision making. CT scan has been shown to have more sensitivity than RT-PCR and Chest X-ray. CT Severity scoring also helps in better assessment of severity of disease. Aim:To estimate typical and atypical chest CT findings in COVID-19 RTPCR positive patients for better assessment of the role of chest CT in COVID-19 management. Materials andMethods:100 patients with confirmed COVID-19 were included in study. Findings like ground glass haze (GGO), reticulations, crazy paving appearance, consolidation, subpleural curvilinear line, bronchiectasis, subpleural transparent line, vascular enlargement, mediastinal lymphadenopathy, nodules, pleural effusion, Inverted halo sign, Halo sign and pericardial effusion were documented in them and analysis was done. Results:The typical Chest CT features present in our COVID-19 cases were GGO in 93 patients (93%), reticulations in 71 patients (71%), crazy paving appearance in 59 patients (59%), consolidation in 47 patients (47%), subpleural curvilinear line in 39 patients (39%), bronchiectasis in 37 patients (37%) and subpleural transparent line in 30 patients (30%). Most cases had bilateral (98%), peripheral (57%) and patchy involvement (86%) by GGO and lower lobe predominance (55%) by consolidation. Conclusion:GGO, reticulations, crazy paving and consolidation involving bilateral lung, in a peripheral and patchy distribution with lower lobe predilection are the typical findings on chest CT in COVID-19. Chest CT scan may act as a quick diagnostic tool with high sensitivity taking into consideration that almost all COVID-19 patients demonstrate typical features.