RADIOLOGICAL EVALUATION AND CORRELATION OF CT SEVERITY SCORING WITH THE CLINICAL OUTCOME IN RT-PCR CONFIRMED COVID-19 INFECTED PATIENTS

Abstract

Background Radiological evaluation of the severity of lung inflammation in Covid-19 patients could provide an objective approach to rapidly identify the treatment modalities and to calculate the duration of hospitalization, need for intubation and ICU stay thereby analyzing and managing the clinical outcome of the patient. Purpose To identify the significant relationship between CT severity score and clinical outcome among RT-PCR confirmed Covid-19 infected patients Materials and Methods Inclusion of 40 patients with COVID-19 confirmed by positive real-time reverse transcriptase polymerase chain reaction on throat swabs underwent High resolution chest CT (7 men and 33 women).The CT-SS was defined by summing up individual scores from 20 lung regions; scores of 0, 1, and 2 were respectively assigned for each region if parenchymal opacification involved 0%, less than 50%, or equal or more than 50% of each region (theoretical range of CT-SS from 0 to 40). The clinical and laboratory data were collected and analyzed. Results All patients (n=16) who underwent intubation died invariably. The lung findings in all patients who died consist of co-existence of Consolidation and ground glass opacities in periphery and central region of lungs. Age is a predominant determinant factor for the course and outcome of disease as 17 patients with a mean age of 62 died when compared to 23 patients alive with a mean age of 47. This implies that mortality has a direct relationship with age. Out of 19 patients who had a CT –Severity score of >19 (Severe), 17 were shifted to ICU and 15 patients died. Only 4 patients recovered. Out of 5 patients whose CT-SS score were < 19, 5 patients were shifted to ICU and 2 cases died. 95 % of Covid-19 positive patients had Fever as their predominant complaint. The results are statistically significant with a p value of <0.01 and specificity of 82.6% and sensitivity of 88.2% Conclusion Along with RT-PCR, CT severity scoring is invariably a valuable modality for the management and planning of treatment for the patients by predicting the prognosis. Summary The chest CT severity score could be used to rapidly identify patients with severe forms of COVID-19 and clearly impacts the outcome of the patients.