The role of computed tomography chest in correlating with the severity and outcome of COVID-19 patients admitted in a tertiary care hospital in South India

Abstract

Aim: To assess the role of computed tomography (CT) chest in correlating with the severity and outcome of COVID-19 Patients. Background and Materials and Methods: A prospective study was done on 160 hospitalized patients who were COVID-19 positive by reverse transcription-polymerase chain reaction in Apollo Hospital, Greams Road, Chennai, India. We collected epidemiological data, comorbidities, clinical manifestations, oxygen requirement, and CT chest details of all patients. All images were reviewed by a single consultant radiologist and CT chest severity scoring was done as per the guidelines published in the American Journal of Radiology. CT chest severity score (CTSS) was then compared with clinical severity and various parameters. Results: This study included 160 hospitalized COVID-19 patients with a mean age of 61 ± 13.97 years. Male (74.4%) patients were more when compared to female patients (25.6%). Majority of the patients were belong to mild category (44.38%), followed by severe (28.7%) and moderate (26.8%) categories. Fever (73.8%) was the most common symptom. Diabetes mellitus (57.5%) was the most common comorbidity of COVID-19 patients in our study, followed by hypertension (55%). The average CTSS of mild category was 7.4 ± 4.7; for moderate category, the mean CTSS was 14.6 ± 5.78; and for severe category, it was 18.3 ± 5.28. There was increasing trend of severity score, as clinical severity increases which was statistically significant (P = 0.0001). The mean CTSS of patients who required no oxygen, low flow oxygen, high flow oxygen, noninvasive ventilation, and intubated patients was 8.3 ± 5.71, 14.84 ± 5.39, 18.17 ± 5.7, 18.17 ± 6.04, and 22.18 ± 4.07, respectively, which was statistically significant (P = 0.0001). The mean CTSS of patients discharged without oxygen requirement was 11.09 ± 6.48 and patients discharged with oxygen requirement was 18.09 ± 6.12 (P = 0.001). The mean CTSS of patients who died was 20.27 ± 4.62. Conclusion: There was a significant correlation between CT chest severity score and clinical severity and oxygen requirement. CT chest is one of the best screening tools for rapid identification as well as to predict the clinical severity; thereby, it helps the clinician in managing the COVID-19 patients at crucial points during the progression of disease.