Role of HRCT in Assessing Requirement of Oxygen for COVID-19 Patients: A Retrospective Study from Amalapuram, Andhra Pradesh, India

Abstract

Introduction: Coronavirus Disease 2019 (COVID-19) infection has affected many countries in the world with its high rate of infectivity and created havoc with its mortality rate. A High Resolution Computed Tomography (HRCT) thorax scan is useful in detection and to assess the involvement of lung which is helpful to plan the management. Aim: To assess the oxygen requirement in COVID-19 patients based on the lung involvement using HRCT scan. Materials and Methods: A retrospective study was conducted from 1st May to 30th June 2021 in the Department of Radiodiagnosis, Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, Andhra Pradesh, India. HRCT thorax scans of 600 patients with COVID-19 infection were included. The patients were categorised based on their lung involvement into three groups (mild, moderate, severe) and then they were followed-up for the oxygen support that each patient received during their stay in hospital. Results: Among the 184 mild COVID-19 infection cases none required Bilevel Positive Airway Pressure (BiPAP)/ intubation. Sixty four out of 340 moderate COVID-19 infection cases required BiPAP and intubation and 28 out 76 severe COVID-19 infection cases required BiPAP and intubation. None in mild cases, 60 (17.6%) in moderate cases, and 32 (42.1%) in severe cases had mortality. The rate of oxygen support and risk of intubation increased as the score increases (p<0.001). The Computed Tomography Severity Index (CTSI) also showed significant difference with the age and co-morbidities of the patients (p<0.01). Conclusion: The HRCT is helpful in assessing the requirement of oxygen support in COVID-19 patients and to plan the management. There is increased non invasive and invasive ventilatory support along with increased morbidity and mortality as the score increases.