Pattern and distribution of lung parenchymal changes in COVID-19 infection on high resolution computed tomography: a descriptive cross-sectional study
DOI:
https://doi.org/10.18203/2320-6012.ijrms20223628Keywords:
COVID-19, High resolution computed tomography, HRCT, GGO, Ground glass opacities, PneumoniaAbstract
Background: This was a descriptive cross-sectional study conducted in a tertiary care hospital in south India during the peak of the COVID-19 infection pandemic in India between June 2020 to June 2021. HRCT lung parenchymal findings of patients with COVID-19 infection were studied, and the pattern and distribution of various lung parenchymal changes in each lung were described. HRCT lung findings were further correlated with clinical findings and clinical severity, which further helped in the clinical management of patients.
Methods: This descriptive cross-sectional study was done at Sagar Hospitals, Tilak Nagar, Jayanagar, Bengaluru on a total of 111 RT-PCR positive COVID-19 patients in the age group 18 to 80. HRCT lung imaging findings were studied from June 2020 to June 2021 during the pandemic. These findings were further correlated with clinical findings and the clinical severity of the patient.
Results: This study showed that chest CT findings in COVID-19 infection are variable. Ground glass opacity was the most common lesion observed, followed by Air space opacification and consolidation with an air bronchogram. In some cases, a crazy-paving pattern, subpleural linear bands, subpleural reticulations and fibrotic streaks were observed. A few cases showed traction bronchiectasis due to adjacent lung fibrosis and lung cyst within lesions. The lesion distribution was both bilateral (more common) and unilateral and showed peripheral predominance. There was a positive correlation between the CT severity score and clinical grading and the clinical severity of the patient.
Conclusions: HRCT lung findings in COVID-19 patients were described in detail, including predominant lesion, predominant pattern, distribution in detail with reference to each lung segment, laterality, and correlation with clinical severity.
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References
Simpson S, Kay FU, Abbara S, Bhalla S, Chung JH, Chung M, et al. Radiological Society of North America Expert Consensus Statement on Reporting Chest CT Findings Related to COVID-19. Endorsed by the Society of Thoracic Radiology, the American College of Radiology, and RSNA- Secondary Publication. J Thorac Imag. 2020;35(4):219-27.
Zhou S, Wang Y, Zhu T, Xia L. CT features of coronavirus disease 2019 (COVID-19) pneumonia in 62 patients in Wuhan, China. Am J Roentgenol. 2020;214(6):1287-94.
Hefeda MM. CT chest findings in patients infected with COVID-19: review of literature. Egypt J Radiol Nucl Med. 2020;51(1):239.
Parekh M, Donuru A, Balasubramanya R, Kapur S. Review of the chest CT differential diagnosis of ground-glass opacities in the COVID era. Radiology. 2020;297(3):E289-302.
Chung M, Bernheim A, Mei X, Zhang N, Huang M, Zeng X, et al. CT imaging features of 2019 novel coronavirus (2019-nCoV). Radiology. 2020;295(1):202-7.
Dai H, Zhang X, Xia J, Zhang T, Shang Y, Huang R, et al. High-resolution chest CT features and clinical characteristics of patients infected with COVID-19 in Jiangsu, China. Int J Infect Dis. 2020;95:106-12.
Bernheim A, Mei X, Huang M, Yang Y, Fayad ZA, Zhang N, et al. Chest CT findings in coronavirus disease-19 (COVID-19): relationship to duration of infection. Radiology. 2020;295(3):200463.
Li K, Wu J, Wu F, Guo D, Chen L, Fang Z, et al. The clinical and chest ct features associated with severe and critical COVID-19 pneumonia. Invest Radiol. 2020.
Salaffi F, Carotti M, Tardella M, Borgheresi A, Agostini A, Minorati D, et al. The role of a chest computed tomography severity score in coronavirus disease 2019 pneumonia. Medicine. 2020;99(42):e22433.
Islam MN, Dipi RM, Mostafa SN, Datta A. Progression of disease in COVID-19 patients evaluated by chest CT imaging and correlated with clinical parameters. Mymensingh Med J. 2021;30(1):182-8.
Zhang J, Wang M, Zhao M, Guo S, Xu Y, Ye J, et al. The clinical characteristics and prognosis factors of mild-moderate patients with COVID-19 in a mobile cabin hospital: a retrospective, single-center study. Front Public Health. 2020;8:264.
Clinical Spectrum. COVID-19 Treatment Guidelines. Available from: https://www.covid19treatmentguidelines.nih.gov/overview/clinical-spectrum/. Accessed on 13 September 2021.
Martínez Chamorro E, Díez Tascón A, Ibáñez Sanz L, Ossaba Vélez S, Borruel Nacenta S. Radiologic diagnosis of patients with COVID-19. Radiologi´a. 2021;63(1):56–73.
Kayhan S, Kocakoç E. Pulmonary fibrosis due to COVID-19 Pneumonia. Korean J Radiol. 2020;21(11):1273-5.
José RJ, Manuel A, Gibson-Bailey K, Lee L. Post-COVID-19 bronchiectasis: a potential epidemic within a pandemic. Expert Rev Respir Med. 2020;14(12):1183-4.
Wasilewski PG, Mruk B, Mazur S, Półtorak-Szymczak G, Sklinda K, Walecki J. COVID-19 severity scoring systems in radiological imaging- a review. Pol J Radiol. 2020;85:e361-8.
Francone M, Iafrate F, Masci GM, Coco S, Cilia F, Manganaro L, et al. Chest CT score in COVID-19 patients: correlation with disease severity and short-term prognosis. Eur Radiol. 2020;30(12):6808-17.
Yang R, Li X, Liu H, Zhen Y, Zhang X, Xiong Q, et al. Chest CT severity score: an imaging tool for assessing severe COVID-19. Radiol Cardiothorac Imag. 2020;2(2):e200047.
Mukaka MM. Statistics corner: a guide to appropriate use of correlation coefficient in medical research. Malawi Med J. 2012;24(3):69-71.
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