Role of ‘Radiological Phenotypes’ in Diagnosis, Treatment and Assessment of Covid-19 Pneumonia: Multicentric study of 6000 cases in tertiary care setting in India

Abstract

<b>Methods:</b> multicentric observational study, included 6000 COVID-19 RT PCR Positive cases with lung involvement on HRCT thorax at entry point &amp; categorised as Radiological presentation phenotypes as severity assessment-mild,moderate,severe as per lung segment involvement (mild&lt;7,moderate 8-15 and severe 16-25),Evolving and Evolved phenotype- with or without GGOs,consolidations,and crazy paving with or without spreading edges,Anatomical phenotype-Unilateral or bilateral as per lung lobe segment or lobe involvement, Clinical-radiological-pathological phenotypes-five types as classical GGOs, consolidations,Bronchopneumonia,Necrotizing pneumonia and cavitating. Response to treatment phenotypes-easy to treat and difficult to treat as per interventions required &amp; response to treatment. Radiological outcome phenotypes as Resolving,Persistent and Progressive as per lung reticular and fibrosing lesions as with or without honeycombing and or tractional bronchiectasis. Statistical analysis by Chi test and students t test and ANOVA. Observations and analysis:In 6000 radiological assessment of covid-19 pneumonia, significant association was documented in Evolving and Evolved pneumonia phenotypes (p&lt;0.000026), Unilateral and Bilateral pneumonia anatomical phenotypes (p&lt;0.00001), Clinical-radiological-pathological phenotypes (p&lt;0.00001), Easy to treat and Difficult to treat pneumonia phenotypes (p&lt;0.00001), Radiological final outcome phenotypes-Persistent, Progressive &amp; Resolving phenotype (p&lt;0.00001) <b>conclusion:</b> Radiological phenotypes will guide in&nbsp;assessing severity, predicting response to therapy and final outcome in covid-19 pneumonia.