MANIFESTATIONS OF PCR POSITIVE COVID 19 PNEUMONIA ON CT CHEST: OUR INITIAL EXPERIENCE AT SHIFA INTERNATIONAL HOSPITAL, ISLAMABAD.

Abstract

PURPOSE:

COVID pneumonia, emerged as a pandemic, is a highly communicable viral infection, pathogen being novel corona virus. Though the definitive diagnosis is established by a positive RT-PCR throat swab; radiological imaging may also provide an important adjunct towards the diagnosis of novel corona virus infection. The first line imaging modalities being radiograph and computed tomography (CT) chest. Purpose of the study was to document the common imaging appearances of emerging novel corona virus disease on CT scan.

MATERIALS AND METHODS:

All the consecutive patients presenting to Shifa International hospital (SIH), Islamabad from February 2020, to May 2020, having RT-PCR positive COVID- 19 infection were enrolled retrospectively with CT chest performed at admission. These imaging scans were evaluated by two independent Consultant Radiologists. Data was analyzed on SPSS v21 and displayed as frequency percentages.

RESULTS:

150 patients (115 (76.7%) men, 35 (23.3%) women; mean age 57.39 ±13.5 standard deviation) were included in the study. The characteristic CT features of COVID 19 pneumonia included ground-glass opacities (GGOs) in 138 patients (92%) which were bilateral, multifocal and multilobar. Among these 138 patients with bilateral and multifocal ground-glass opacities (GGOs) with concomitant consolidations were present in 41 (29.7%) and crazy paving was seen in 105/138 scans (76%). 5 out of 150 patients lacked these GGOs and showed consolidations without GGOs. Other imaging features included subpleural lines in 10 patients (6%), vascular dilatation in 22 patients (14.6%) and air bronchograms in 30 patients (20%). Pleural effusion in 3 scans (2%). None of the initial cases showed enlarged lymph nodes. 7 out of 150 scans (4.6%) had no positive findings. Predominantly peripheral and bilateral distribution in 146 of 150 scans (97.3%).

CONCLUSION:

According to our initial experience, the imaging appearances of COVID 19 infection on CT chest compromises of predominantly bilateral, multilobar and multifocal GGOs. Crazing paving and concomitant consolidations may or may not be seen. Other commonly reported features were subpleural lines, vascular dilatation and air bronchograms with pleural effusions being the least common.

KEY WORDS:

Corona virus, Computed tomography (CT), PCR, ground glass opacities, consolidations, air bronchograms, pleural effusion.