Role of CT Chest in the Diagnosis and Management of SARS-Cov-2 Pneumonia Patients - Hospital Based Descriptive Study, Hyderabad

Author(s): P.M.T. Mahidhar1, Gayathri Gadiyaram2, Rakhee Kumar Paruchuri3

The computerised tomography (CT) characteristics of COVID-19 are reported and
compared with the CT characteristics of other viruses to familiarise radiologists
with potential CT trends and to determine the effectiveness of chest CT in the
diagnosis and treatment of COVID-19.
This was a hospital based descriptive study which involved the first 324 patients
with a finding of severe acute respiratory syndrome (SARS-CoV-2) infection
validated by real-time reverse transcription-polymerase chain reaction (RT – PCR).
Monitoring patients (198 males, 126 females with a mean age of 46.50 years ±
8.96 [SD] and age range of 21 - 76 years) from April 2020 to July 2020. We
correlated the image reports from the initial CT analysis with the findings of the
laboratory studies and established possible CT patterns for viral infection.
The initial chest CT studies of the 324 SARS-CoV-2 patients showed that the
disease affected all 'five lobes' in 248 (76.54 percent) patients, both 'lower lobes'
in 49 (15.12 percent) patients, the right lower lobe in 23 patients (7.10 percent),
and the left lower lobe and right middle lobe in 2 patients (0.62 percent). In 303
(93.52 percent) patients, the lesions were primarily peripheral and subpleural; and
there were fewer lesions along the bronchovascular bundles. Two major patterns
of SARS-CoV-2 lesions on CT images are GGO (ground - glass opacity) and
consolidation. In 303 of the 324 patients (93.52 percent), CT showed single or
multiple abnormal GGO or consolidation, or both. In the remaining 21 (6.48
percent) cases, neither GGO nor consolidation was observed on CT. Follow-up CT
showed moderate or pronounced disease worsening in 12 out of 58 (20.69
percent) cases and follow-up CT showed improvement with the appearance of
fibrosis and GGO resolution.
In conclusion, the use of a chest CT system in SARS-CoV-2 patients can accurately
evaluate pneumonia. Most notably follow-up CT scans may help assess patients
with SARS-CoV-2 pneumonia in their response to treatment.