Radiographic manifestations of COVID-19 pneumonia: Initial experience from an epicenter in North-West, Nigeria

Abstract

Background: COVID-19, a zoonotic disease caused by severe acute respiratory syndrome coronavirus-2, is responsible for the pandemic of 2020. Despite the availability and usefulness of chest radiographs (CXR) in diagnosis and monitoring of suspected as well as infected patients with COVID-19, there is paucity of studies about imaging findings in COVID-19 from Sub-Saharan Africa including Nigeria. Aim: This study aims to describe the findings and correlates of chest radiographic appearances in COVID-19 pneumonia at Kano, Nigeria. Materials and Methods: This was a retrospective study conducted at radiology units of four radiology diagnostic facilities that were very active during the peak period of the pandemic in Kano metropolis. All patients with confirmed COVID-19 infection and also underwent chest radiographic examinations at these facilities were included. The findings considered in the evaluation were the presence or absence and the type of pulmonary or pleural lesions/abnormality, and their distribution; including their association with demographics and clinical presentations. Statistical analysis was performed using SPSS version 23.0. Results: Of 125 patients, 98 (78.4%) were male. The mean age was 57.3 ± 12 years. One hundred and one (80.8%) of them had abnormal chest radiographic findings. These patients showed significant higher occurrences of anosmia than those with normal CXRs (P < 0.05). The occurrence of ground-glass opacity in both lower zones was significantly seen in 43 (62.3%) patients between 40 and 60 years and in 40 (85%) of those older than 60. Anosmia and age were respectively the only symptoms that independently predict if the COVID-19 patient may likely present with the abnormal CXRs or not (0.175 [0.057–0.542] P = 0.002; 3.7 [1.423–9.622] P = 0.007). Conclusions: Majority of our patients presents with abnormalities on CXRs. Older age, anosmia were the major predictors of chest radiographic abnormalities, which were mainly bilateral asymmetric lower zones ground glass opacities.