Radiological and Clinical Pattern in Severely/Critically ill COVID–19 Positive Patients

Abstract

Background: Radiological role is not only in the early detection of lung disease, but also to determine its severity, its complications like acute respiratory distress syndrome and superadded bacterial infection. Objective: To determine the radiological and clinical pattern in severely / critically ill COVID – 19 positive patients admitted in High Dependency Unit / Intensive Care Unit of Mayo Hospital Lahore. Methodology: This descriptive study was conducted in Institute of Chest Medicine Mayo Hospital Lahore which continued over a period of 6 weeks. 50 patients who were r RT-PCR COVID-19 positive and were hemodynamically unstable admitted in HDU/ICU of Mayo Hospital from 16th April 2020 to 30th May 2020 were included. All these patients had positive X-ray findings. Results: Study comprised of 50 patients, 34 (68%) males and 16 (32%) females. Presenting complaints were fever 22 (44%), dry cough 10 (20%), dyspnea 10(20%), sore throat 4 (8%), loss of sense of smell 2(4%) and fatigue with body aches 2(4%). Majority of patients i.e 28 (56%) patients had typical X-ray chest findings of COVID-19 pneumonia of L phenotype in which there was peripheral, basal ground glass opacity with or without superadded consolidation bilaterally. Diffuse pattern of disease of H phenotype with peripheral, upper zones, middle zones involvement along with lower zones disease was seen in 7 (14%) patients. Conclusion: X-ray chest demonstrated a mixed pattern of ground glass opacities / consolidation mainly in peripheral and bilateral lower lung zones with predominantly L phenotype of pneumonia in severely / critically ill COVID-19 patients which was out of proportion to their clinical parameters.