Progression of Disease in COVID-19 Patients Evaluated by Chest CT Imgaing and Correlated with Clinical Parameters

The objective of the study was to investigate and quantify the severity of COVID-19 infection by high resolution computed tomography (CT) of chest and to determine its relationship with clinical parameters. This study also aimed to see CT changes with clinical recovery or progression of disease. This cross sectional study was performed from July 20 to August 20, 2020, where both chest HRCT and clinical features were included in laboratory confirmed COVID-19, 100 patients, attending the depertment of Radiology & Imaging, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. This study included clinical symptoms, comorbidities of patients, HRCT chest characteristics, CT severity score. After collection of all required data and careful medical chest review, the clinical data of laboratory confirmed patients was compiled and tabulated. In this study group out of 100 patients, most of the patients were in 5th & 6th dacades with a mean age of 53.7 years. In this study out of 100 patients 72% were male and 28% were female with an average sex ratio of male : female being 2.5:1. Prevalance of various clinical presentation in this study sample population distributed as fever in 76% cough in 77.4%, shortness of breath in 55%, sore throat in 17% were the most common clinical manifestations while a few patients (13.2%) also had other symptoms like headache, chest tightnes, anosmia and diarrhoea. Major comorbid conditions were diabets mellitus, hypertension, bronchial asthma and Chronic kidney disease (CKD). Patient with comorbid disease, especially if multiple had higher symptomatic presentation. Out of 100 patients 75.5% patient had co-morbidity where as 24.5% ptaients did not have any co-existing disease. According to HRCT imaging severity score the lung pathological changes were evaluated, when typical covid findings in 80%, intermediate in 10%, atypical in 2% and normal chest CT findings in 8% patients. Symptomatic presentation had found higher (85.21%) who had CT severity index >15/25 while sympotomatic presentation lesser (14.79%) who had CT severity index <15/25. CT severity index of 1-5 was seen in 20(21.73%) patients, 6-10 in 38(41.30%) patients, 11-15 in 22(23.91% patients, 16-20 in 10(10.86%) patients and 21-25 in 2(2.17%). As positive CT findings were more prominent in symptomatic and co-morbid patients HRCT chest in COVID-19 patient had a major diagnostic and prognostic importance. Clinical symptoms of patients directly correlated with CT severity score. Therefore, CT imaging was found to be useful in predicting clinical recovery of patient or progression of disease.