Spectrum of High Resolution Computed Tomography Findings in COVID-19 Infection

Abstract

Coronavirus disease 2019 (COVID-19) is an infectious disease which is caused by a newly discovered virus named Corona Virus. Objective: To explore HRCT findings of COVID-19 related pulmonary disease in Pakistan. Methods: A prospective study involving 316 patients (age 18-40 years) with suspicion of coronavirus and symptoms such as cough and dyspnea was conducted from 20th March 2020 to 20th May 2020( 2 month period) at Radiology Department, Fatima Jinnah Medical University affiliated sir Ganga Ram Hospital, Lahore. The sample collection was non probability consecutive technique. All patients underwent RT-PCR and chest CT. Appearances of HRCT were assessed in those patients who had positive RT-PCR as well as had findings on HRCT i.e had positive HRCT. Patients excluded from study on basis of indications other than COVID-19, poor quality of images due to breathing artefact and failure to get consent for imaging. Results: A total of 316 patients participants with suspected coronavirus were included in consecutive study as per inclusion and exclusion criteria. Of these, 182 patients were male and 134 patients were female. They range in age from 18 to 89 years having a mean of 57±17 y. Out of 316 patients, 179, 154 patients had positive PCR and positive HRCT findings, 25 had positive PCR but no HRCT findings. Ground glass opacity and multilobe involvement (≥ 2 lobes) was present in (85%) patients, consolidation in (77%) patients, air bronchogram in (61%) patients and bronchiectasis in (41%) patients. Of study participants 27% patients had pleural effusion (20%) had mediastinal lymphadenopathy. Conclusion: The ground glass opacification was found to be most common HRCT finding in patients with COVID-19 pulmonary involvement. These ground glass opacities were commonly found to be located posteriorly and peripherally involving multiple lobes of both lungs in majority of the cases. Other common findings include consolidation associated with air bronchogram and bronchiectasis.