EVALUATION OF THE PERFORMANCE OF HRCT IN THE DIAGNOSTIC AND MANAGEMENT OF COVID-19

In todays global health pandemic, high resolution computed tomography (HRCT) of chest became an important tool for early diagnosis, evaluation of disease progression and prompt management of COVID-19 patient. HRCT of Chest is also an important complement to the reverse-transcription polymerase chain reaction (RT-PCR) tests. The aim of this study was to assess different patterns of appearance in HRCT chest in COVID-19 infection & to grade the severity by observing a sample of 50 after the symptoms began. In this study, 50 patients had been selected from a private hospital of Dhaka, Bangladesh who came for HRCT chest to diagnose COVID- 19. The data were collected from 11 April 2020 to 27 May 2020. Distribution and patterns of pulmonary lesions like ground glass opacity (GGO), consolidation, reverse halo sign, crazy paving, thickened vascular marking, lymphadenopathy and pleural effusion were evaluated. It was also assessed the involvement of lung lobe, percentage of lung involvement and total severity score. Among 50 patients diagnosed with COVID-19, most of patients had fever (64%) and dry cough (50%). 30% patients had come with shortness of breath. There were 28 (56%) males and 22 (44%) females aged 20 to 85 years. The highest number of patients were in the age range 40 to 49 years. The CT abnormality of ground glass opacity (GGO) was shown in all 50(100%) cases. Moreover 22(44%) cases had GGO plus consolidation. Crazy-paving pattern was in 16(32%) cases. In case of lobe involvement, most patients, 43 (86%) had involvement of all the 5 lobes and right lobe involvement were the most. The lesions were mostly peripheral (17, 34%) and in 5(10%) cases the distribution were diffuse but predominantly peripheral. Total severity score was categorized into 5 groups (0, 1-5, 6-10, 11-15, 16-20). Most of the patients (19, 38%) were in total severity score ranging from 16-20. In case of total percentage of lung involvement maximum patients (32, 64%) were in the range of 1- 25% and maximum lung involvement (76-100%) was seen in only 1 case. HRCT of chest may be useful for the rapid diagnosis of COVID-19 to optimize the management of patients. However, CT has still limitation for identifying specific viruses and distinguishing between viruses.