CT Imaging Features of Patients with COVID-19 at a Tertiary Care Hospital: Experience from Pakistan
DOI:
https://doi.org/10.1996/pjcm.v28i3.748Keywords:
Coronavirus, COVID-19, Computed Tomography, HRCT, Ground Glass OpacityAbstract
Background: Coronavirus disease 2019 (COVID-19) patients’ manifest symptoms of mild to severe disease leading to acute respiratory distress syndrome (ARDS) and multi-organ dysfunction. Chest computed tomography (CT) is considered one of the important modalities for the diagnosis and assessment of progression of disease. Bilateral ground glass opacification with a predominant peripheral distribution seen with consolidation and interstitial thickening on CT scan are currently considered the radiological hallmarks of the disease. Objective: The objective of the present study is to determine the salient features of CT chest in patients with COVID-19 from the largest tertiary care centre in Karachi, Pakistan. Methodology: This cross-sectional research study was conducted at the Aga Khan University Hospital from April 2020 to December 2020. Adult patients who had a positive COVID-19 PCR and underwent a chest CT scan were included in the study. Patients were scanned in supine position using either non-contrast high-resolution CT (HRCT), arterial phase chest CT, or CT pulmonary angiogram (CTPA). The CT findings recorded included presence or absence of ground glass opacity (GGO), consolidation, air bronchogram, vascular enlargement, linear opacities, crazy paving, halo sign, reverse halo sign, fibrosis, cavities, tree in bud, mediastinal/hilar lymphadenopathy, pleural effusion, and any additional finding such as pneumothorax, pneumomediastinum, or traction bronchiectasis. Results: Of 110 patients, 70 (63.7%) were males and 40 (36.3%) were females, with a mean age of 56.5 ± 14.8 years (range 46–67 years). Ground glass opacity (GGO) was the most common (79.1%) CT feature, followed by consolidation (56.4%), linear opacities (40%), and crazy paving patterns (32.7%). The common distribution of the abnormalities according to HRCT and contrast CT were peripheral (54.1%) and both peripheral and central (60%), respectively. Conclusion: GGO is the most common CT scan feature in patients with COVID-19, followed by consolidation, linear opacities, and the crazy paving pattern. Keywords: Coronavirus; COVID-19; Computed Tomography; HRCT; Ground Glass OpacityReferences
Sohrabi C, Alsafi Z, O'Neill N, Khan M, Kerwan A, AlJabir A, et al. World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). International journal of surgery (London, England). 2020;76:71-6.
Singhal T. A Review of Coronavirus Disease-2019 (COVID). The Indian Journal of Pediatrics. 2020;87(4):281-6.
Ye Z, Zhang Y, Wang Y, Huang Z, Song B. Chest CT manifestations of new coronavirus disease 2019 (COVID): a pictorial review. European Radiology. 2020.
Carotti M, Salaffi F, Sarzi-Puttini P, Agostini A, Borgheresi A, Minorati D, et al. Chest CT features of coronavirus disease 2019 (COVID-19) pneumonia: key points for radiologists. Radiol Med. 2020;125(7):636-46.
Caruso D, Zerunian M, Polici M, Pucciarelli F, Polidori T, Rucci C, et al. Chest CT features of COVID-19 in Rome, Italy. Radiology. 2020;296(2):E79-E85.
Xiong Y, Sun D, Liu Y, Fan Y, Zhao L, Li X, et al. Clinical and High-Resolution CT Features of the COVID-19 Infection: Comparison of the Initial and Follow-up Changes. Investigative radiology. 2020;55(6):332-9.
Bernheim A, Mei X, Huang M, Yang Y, Fayad ZA, Zhang N, et al. Chest CT Findings in Coronavirus Disease-19 (COVED): Relationship to Duration of Infection. Radiology. 2020;295(3):200463.
King MJ, Lewis S, El Homsi M, Meza GH, Bernheim A, Jacobi A, et al. Lung base CT findings in COVID-19 adult patients presenting with acute abdominal complaints: case series from a major New York City health system. European radiology. 2020;30 (12):6685-93.
Alam SZ, Al Muid S, Akhter A, Rahman AS, Al Emran M, Al Mostakim MT. HRCT Chest Evaluation of COVID-19 Patients: Experience in Combined Military Hospital Dhaka, Bangladesh. Journal of Bangladesh College of Physicians and Surgeons. 2020:21-8.
Parry AH, Wani AH, Yaseen M, Dar KA, Choh NA, Khan NA, et al. Spectrum of chest computed tomographic (CT) findings in coronavirus disease-19 (COVID-19) patients in India. European Journal of Radiology. 2020;129:109147.
Tabatabaei SMH, Talari H, Moghaddas F, Rajebi H. CT Features and Short-term Prognosis of COVID-19 Pneumonia: A Single-Center Study from Kashan, Iran. Radiology: Cardiothoracic Imaging. 2020;2(2):e200130.
Khan SP, Izhar S, Kadri S. Role of Radiological Investigations of COVID-19 Patients with Pneumonia, Karachi Pakistan. Open Journal of Radiology. 2021;11(01):10.
Qureshi AR, Akhtar Z, Irfan M, Sajid M, Ashraf Z. Diagnostic value of HRCT-Thorax for pandemic COVID-19 pneumonia in Pakistan. Journal of Rawalpindi Medical College. 2020;24(Supp-1):77-84.
Khaliq M, Raja R, Khan N, Hanif H. An Analysis of High-Resolution Computed Tomography Chest Manifestations of COVID-19 Patients in Pakistan. Cureus. 2020;12(7).
Austin J, Müller NL, Friedman PJ, Hansell DM, Naidich DP, Remy-Jardin M, et al. Glossary of terms for CT of the lungs: recommendations of the Nomenclature Committee of the Fleischner Society. Radiology. 1996;200(2):327-31.
Wu J, Wu X, Zeng W, Guo D, Fang Z, Chen L, et al. Chest CT findings in patients with coronavirus disease 2019 and its relationship with clinical features. Investigative radiology. 2020;55(5):257.
Pan Y, Guan H, Zhou S, Wang Y, Li Q, Zhu T, et al. Initial CT findings and temporal changes in patients with the novel coronavirus pneumonia (2019-nCoV): a study of 63 patients in Wuhan, China. European Radiology. 2020;30(6):3306-9.
Sun Z, Zhang N, Li Y, Xu X. A systematic review of chest imaging findings in COVID-19. Quantitative imaging in medicine and surgery. 2020;10(5):1058-79.
Salehi S, Abedi A, Balakrishnan S, Gholam rezanezhad A. Coronavirus Disease 2019 (COVID): A Systematic Review of Imaging Findings in 919 Patients. American Journal of Roentgenology. 2020;215(1):87-93.
Salehi S, Abedi A, Balakrishnan S, Gholamrezanezhad A. Coronavirus Disease 2019 (COVID): A Systematic Review of Imaging Findings in 919 Patients. AJR Am J Roentgenol. 2020;215(1):87-93.
Cao Y, Liu X, Xiong L, Cai K. Imaging and clinical features of patients with 2019 novel coronavirus SARS-CoV-2: a systematic review and meta analysis. Journal of medical virology. 2020;92(9):1449-59.
Ng MY, Lee EYP, Yang J, Yang F, Li X, Wang H, et al. Imaging Profile of the COVID-19 Infection: Radiologic Findings and Literature Review. Radiol Cardiothorac Imaging. 2020;2(1):e200034.
Ye Z, Zhang Y, Wang Y, Huang Z, Song B. Chest CT manifestations of new coronavirus disease 2019 (COVED): a pictorial review. European radiology. 2020;30(8):4381-9.
Yang ZL, Chen C, Huang L, Zhou SC, Hu YN, Xia LM, et al. Fibrotic Changes Depicted by Thin-Section CT in Patients With COVID-19 at the Early Recovery Stage: Preliminary Experience. Frontiers in Medicine. 2020;7:833.
Scelfo C, Fontana M, Casalini E, Menzella F, Piro R, Zerbini A, et al. A Dangerous Consequence of the Recent Pandemic: Early Lung Fibrosis Following COVID-19 Pneumonia–Case Reports. Therapeutics and clinical risk management. 2020;16:1039
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Pakistan Journal of Chest Medicine
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
