Cross Sectional HRCT Pulmonary Findings in Patients with COVID-19

Objective: HRCT chest provides an effective modality to evaluate patients with suspected coronavirus disease 2019 (COVID-19). While radiologists get familiar with the imaging appearance of this disease to identify its presence, confronting this virus during imaging investigations is challenging in the setting of other pulmonary pathologies and the purpose of this study after performing real-time reverse transcription polymerase chain reaction (RT-PCR) testing, is to review and analyze the CT chest manifestations pertaining to COVID-19 in a cohort of 12patients who presented with general viral flu clinical symptoms of fever, chest pain, severe cough and headache with body tenderness, sore throat, and lethargy. Method and Materials: This retrospective study was conducted during the period from Oct 2020 to Nov 2020. The examined cross sectional imaging studies involved two institutions, an imaging laboratory clinic and a tertiary academic hospital. Salient imaging findings and medical history were reviewed of patients who underwent RT-PCR testing and resulted positive during their visit to the Emergency (ER) and hospital admission. Key Results: Based on the diagnostic specificity and sensitivity of CT scanning in a total of 12 COVID-19 RT-PCR positive patients of the ages ranging from 22-80 years, mean age ? standard deviation, 50 years ? 18 and the following features were evident: a) 3-4 (33%) had confluent ground-glass opacities (GGO), 7-8 (75%) had GGO opacities with a patchy morphology, 7-8 (66%) had a peripheral distribution of disease, 3-4 (29%) had consolidation with ground-glass opacities, 11 (91%) had inter-septal thickening and 4-5 (41%) had crazy-paving pattern. One patient demonstrated consolidation without ground-glass opacification and no patients had cavitation in the lung, discrete pulmonary nodules, pleural effusions but signet ring sign, sub-pleural banding, pleural thickening, and fibrosis were present in 2-3 (10%) patients. b) Pleural effusions, solitary nodule, nodal calcifications, abscesses, lung cavitation, pnuematoceles, reticulation or ILD features were absent. c) Associated findings such as air-bronchgram, bronchial wall thickening/dilatation, sub-pleural bandings, reverse halo sign, pleural thickening (basal) were present in less than5 (10%) patients. Conclusion: COVID-19 manifests with a spectrum of characteristic chest CT imaging features, which are helpful to the radiologist for co-relation and early diagnostic detection of this emerging global health emergency.