Radiological Patterns of Lung Injury on HRCT in COVID-19 Patients: An Experience From Tertiary Care Centre in India

During the outbreak of the COVID-19 pandemic, radiological examinations became crucial in assessing the severity and progression of lung injuries in COVID-19 patients. This study was done to identify radiological patterns of lung injuries in COVID-19 patients, assess lobar involvement, and perform CT severity scoring on symptomatic patients on a baseline scan. All the RT-PCR-positive patients were retrospectively enrolled in the study from August 16, 2020 to October 12, 2020. The final heart-resolution computed tomographic (HRCT) thorax data of a total of 119 COVID-19 patients was analyzed using simple statistical methods. A p-value of less than 0.05 (p < 0.05) was considered statistically significant. A total of 119 HRCT thorax scans of symptomatic indoor RT-PCR-positive patients were reviewed. Over 50% of the patients were under 50 (n = 66; 25 = 5; 25-50 = 61). Males > females: 3.25:1 (M = 91; F = 28). Peripheral involvement dominated (n = 90). Both lungs were affected equally, but the right lower lobe was more involved (n = 103) than the left (n = 98). Inpatient care was needed for 64.70% of CT severity score (CTSS) 10 COVID-19 patients (n = 77). Most positive CT scans (n = 115) revealed ground glass opacities (n = 112; 97.39%). Vascular dilatation or vasculitis (n = 65; 56.62%) and organizing pneumonia-like changes (n = 61; 53.04%) were also common. Vascular enlargement (56.53 percent, n = 65) and reverse halo (52.17%, n = 60) were the most common CT signs. The most common chest CT finding in COVID-19 was ground-glass opacity in peripheral distribution with extensive lung involvement. These ground glass opacities may coalesce into consolidations. Vascular dilatation, organizing pneumonia, interlobular septal thickening, and crazy paving were other important imaging characteristics.