ABSTRACT
Background and Objectives: Radiology emerged as one of the frontline clinical services in the COVID-19 pandemic. This audit study aimed to evaluate the impact of COVID-19 on the radiological services in a tertiary care hospital in terms of workload and case mix. Methods: We compared the overall workload of the radiology department between March 2019 to December 2020, emphasizing the number of CTs and Chest radiographs performed during the pandemic. The first period starting when the first confirmed case presented to our hospital and the second control period in the same months in 2019. The imaging parameters included the total number of CTs, MRIs, Ultrasounds, Radiographs, CTs from the emergency room (ER), OPD, IPD, CT chest performed for COVID-19 and other emergency indications. All parameters were calculated by taking average each month in both study periods. Results: An overall decrease was observed in the number of all primary imaging modalities during the pandemic, with ultrasound showing a maximum reduction in numbers (36.5%) followed by radiographs (29.6%) and MRIs (13.8%) compared to 2019. However, total CTs showed a minimal decrease of 1.6% with a significant leap in HRCTs performed reaching up to 80.5%. Conclusion: COVID-19 and resultant movement restrictions, although they did lead to a reduction in overall radiology work volume, were compensated by an increase in the number of studies performed through emergency and for management of COVID-19 infection.
ABSTRACT
OBJECTIVE: To determine a cut-off value of Chest CT severity score (CT-SS) in order to discriminate between the clinical types of COVID-19 pneumonia. STUDY DESIGN: Observational study. PLACE AND DURATION OF STUDY: Department of Radiology, Shifa International Hospital, from 1st March to June 30th, 2020. METHODOLOGY: One hundred and three consecutive patients' RT PCR positive for COVID-19 were included. Two consultant radiologists, with experience of 7 to 10 years in body imaging, evaluated their HRCT studies in consensus and calculated the CT severity score. A scoring of all 20 individual regions in each lung were assigned by the radiologists attributing a score of 0, 1 or 2 to each region, if parenchymal opacification was none, less than 50%, or 50% or more, respectively. The CT severity score was a summation of scores of all 20 regions of both lungs combined with a range of 0 to 40 points. The scores were compared for clinically mild and severe disease. RESULTS: Significant differences were noted regarding the scoring of lung opacity in mild and severe groups in each lung segment, p <0.05. The most significantly involved segments were right lower lobe's medial and lateral basal segment, left upper lobe's superior lingular segment and left lower lobe's medial basal and lateral basal segments. To discriminate mild versus severe disease, CT-SS threshold value turned out to be 19.5 Conclusion: CTSS may be of value for a prompt and objective means of assessing the degree of severity and disease burden in lungs. Key Words: COVID-19, COVID-19 diagnosis, Pneumonia, Novel coronavirus, CT severity score, Respiratory tract infection, Triage, Pandemic, RT-PCR, SARS-COV 2, Outbreak.
