Abstract

High-resolution computed tomography (HRCT) chest is rapid and has a strong sensitivity for diagnosing viral pneumonia including COVID 19 disease in its early stages in comparison to RT-PCR, thus being crucial in triaging patients for treatment and isolation, to prevent further transmission of the disease. In this study we are going to analyse the temporal changes in imaging findings of COVID-19 on HRCT chest. Methods: prospective study was conducted in the Department of Radiology of an exclusive 500 bedded COVID Hospital in Bhubaneswar, Odisha, India. Evaluation of hundred patients was done based on inclusion and exclusion criteria, after obtaining informed consent over a period of 2 years from September 2020 to September 2022. All pertinent epidemiological data was gathered from hospital records. All COVID 19 RT-PCR positive patients who underwent HRCT Chest on admission and repeat scan within 30 days, following the progression of the disease were included. Those who were clinically suspected COVID cases but were RT PCR negative on RT-PCR testing, were excluded. Results: HRCT chest demonstrated diffuse ground glass opacities to be the predominant finding (55%) with the associated findings of sub pleural atelectatic bands (31%) and septal thickening (23%). There was a positive correlation of blood parameters like CRP in COVID patients. A higher incidence was found in patients with Type-2 diabetes mellitus, followed by those with hypertension. In majority of the cases (80%) bilateral lungs and in about 81% cases, two or more lung lobes were involved. Mild and moderately ill patients were found to have a CTSS (CT severity score) in the score range of 15-25. Typical category was the most common type followed by atypical and indeterminate categories. Conclusions: ‘Typical pattern’ along with diffuse ground glass opacities of multiple lobes in the HRCT chest was the most common pattern of lung involvement. High Computer Tomography Severity Score (CTSS) corresponds to a higher disease severity, which helps in taking a timely decision for early treatment. HRCT Thorax has early and fast diagnostic capability as compared to RT-PCR in the detection of COVID-19. The elderly and those with comorbidities are at a higher risk of developing severe disease. Blood parameters like CRP can be used for disease monitoring and follow-up purposes

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