ABSTRACT

Background:The radiologic parameters of covid-19 (corona virus disease-2019) is displayed mainly by CT but the detail report of chest radiographs in accordance with the time period of the disease is absent.

Purpose:The objective of this study was to analyze the severity of Covid-19 findings on the chest radiographs and to evaluate the disease time course. The aim of the study also included the evaluation of relation between these findings on chest radiograph and RT-PCR(real-time reverse transcription polymerase chain reaction) test for SARS COV-2 nucleic acid.

Methodology:This study was retrospective in which admitted Covid-19 patients (during April-June 2020) inCivil Hospital and Khairpur Medical College, Khairpurwere analyzed through chest radiographs and RT-PCR and was approved by institutional review boards. Consents from all participants included in this study was taken. 74 patients were taken from Civil Hospital Khairpur. The positive covid-19 was evaluated through RT-PCR test done on swabs taken from nasopharynx and throat. 42 patients possessed serial results of RT-PCR. The chest radiography was done on all patients except one. The time course of symptoms was acquired from epidemiological data of public given by the Health department. In a-symptomatic patients (11 out of 74 concluding the date of positive RT-PCR test result was added to analyze onset of symptoms.

The radiologists scored the radiographs of chest on the basis of ground-glass opacity, consolidation, pleural fluid as well as the location. Severity index of each lung was analyzed, and scores were added to obtain the final severity score.

Results:The clinical presentations of 74 patients in which 31 (42%) were males and 43 (58%) were females included in this study. (the mean value of age was 61 years and the range of age was 18 to 80 years). Fever (44 patients; 59.4% as well as cough (30 patients; 41%) were commonly present in the patients. About 11 patients (15%) presented as asymptomatic. The comorbidities like hypertension were present in 16 patients (22%) and diabetes was present in 10 patients (14%). 49 patients displayed abnormal chest radiographs during their course disease. The baseline radiograph of chest reveals consolidation as commonest presentation in about 34 patients (46%), and ground glass opacity in 25 patients (34%). The common locations were peripheral distribution in 30 patients (41%) and lower zone involvement in 36 patients (49%). 36 out of 74 (49%) patients had bilateral involvement of lungs. Only three patients (4%) presented with pleural effusion. All patients were evaluated through baseline chest radiographs in which 25 patients (34%) presented with normal results.

Conclusion:The radiographic examinations of Covid-19 patients revealed bilateral consolidation in lower zones of lungs reaching at peak within 10 to 12 days from the time of onset of the symptoms.