Different Patterns of HRCT Chest in patients with 2019 novel coronavirus SARS-CoV-2

Abstract

Background: Coronavirus disease 2019 (COVID-19) is an acute pneumonia caused by the β-coronavirus ‘severe acute respiratory syndrome coronavirus’ (SARS-CoV-2). Up till now six different species of coronavirus have been recognized which cause disease. Four of them caused common cold symptoms while other two severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) cause fatal sickness. Methods: Sample of 100 patients were collected between April 2020 to November 2020  in Nishter University Hospital Multan. Sample included 64 Males and 36 Females having age ranging from 28 to 92 years. We analyzed the clinical characteristics of the patients, as well as the distribution characteristics, pattern, morphology, and accompanying manifestations of lung lesions with number of lobes involved on HRCT chest. . Results: The majority of the infected patients were having common pattern of   Ground Glass Opacities (84%). Different other patterns included Consolidation (41%), Infiltrates (28%), Reverse halo (4%), Crazy Paving (4%), Vessel wall widening (30%), Spider web sign (4%), Septal thickening (38%). Combination of different pattern include GGO with consolidation (33%), GGO with infiltrates (28%), GGO with reverse halo sign (4%). Distribution of pattern was symmetrical (16%) and asymmetrical (84%), Peripheral (100%) and central (0%), sub pleural (20%) and basal (100%), both basal and sub pleural (20%). Number of lobes affected by COVID were: one lobe (0%), two lobes (8%), three lobes (42%), four lobes (25%) and five lobes (25%) Almost 50 cases out of 100 had four or five lobes affected. Conclusion:   Our study included those patients who were having respiratory Or gastrointestinal symptoms and all were PCR positive. We observed that most common pattern on HRCT was Ground glass (84%). Other patterns observed were Consolidation, Infiltrates, septal wall thickening, GGO with consolidation, GGO with infiltrates. Less common patterns were Reverse halo, crazy paving and GGO with reverse halo 4% each. Most common distribution pattern was basal, peripheral, sub pleural and asymmetrical. We observed that COVID involved multiple lobes. Keywords: HRCT Chest; SARS-COV-2; GGO; Crazy Paving; Consolidation