Abstract

Pulmonary Radiological Findings in COVID-19 Patients

Background: COVID-19 is a pandemic infectious disease causing an increase in deaths. The clinical spectrum of this disease ranges from asymptomatic to mild clinical upper respiratory infection, which can progress to an acute respiratory distress syndrome in critically ill patients. Reverse Transcription Polymerase Chain Reaction (RT-PCR) and Computed Tomography (CT) have played important roles in diagnosing the disease. The study aimed to evaluate the damage to lungs during the COVID-19 pandemic by imagery diagnostic methods like CT and x-ray with the suggested objective that imaging plays an important role in the clinical work-up of suspected or confirmed COVID-19 patients. Methods: This is a retrospective and observational study, including the collection and assessment of demographic, laboratory, and clinical data of patients with and without a confirmed diagnosis of Covid-19 infection by RT-PCR, who underwent chest x-ray and CT at the hospital between November 2020 to January 2021. X-ray and CT scans were viewed and analyzed by two blinded consultant radiologists, and were classified as positive or negative and also assessed the clinical severity of patients. The software SPSS version 20.0 were used for analyzing data. A p-value less than 0.05 was considered statically significant. Results: Overall 225 patients, the positivity of COVID-19 by RT-PCR resulted at 85.3%. Males were the most predominant gender and patients over 61 years old appeared the higher number at 47.1%. The fever was the most frequent symptom 82.6% compared to other symptoms of COVID-19. About 36% of patients referred have sputum production 67.5% shortness of breath, and 34% pleuritic pain. The maximum of lungs involved peaked approximately 11 days from the onset of initial symptoms, p<0.03. Related to the comorbidities, 31.1% referred that they suffer from arterial hypertension. The radiological images of most of the patients resulted in ground-glass opacities and consolidations and peripherical distribution in 67.1%, 56.9%, and 60% respectively radiological investigations indicate that among the 254 patients, 51% had features on both lungs; 9% on the left lung; and 11% on the right lung. The predominantly affected lobe was the right lower lobe 67.5%. Conclusions: RT-PCR test continues to be considered the initial step for diagnosing COVID-19, even though the publications studies reported many false-negative cases for many reasons. Chest X-ray and CT remains the primary imaging modality in patients with all types of respiratory infections, especially during the different wave of COVID-19 in Albania. Moreover, a chest CT demonstrates lower respiratory tract affection. The CT findings in patients confirmed or not confirmed with COVID-19 can help to predict the course of the disease. This can help to manage the patients, and plan the resources more effectively, especially for the use of hospitalization beds in ICU wards, and also, will decrease the spread of disease by providing early time to intervene to isolate patients.

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