High resolution computed tomography guided anatomico-pathological scoring system for stratifying and prognosticating pulmonary manifestations of COVID-19

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Original Article

Author Details : Dhaval Dalal*, Ankush Govindwar, Gaurav Gangwani, Medha Panchal, Vijaykumar Gawali

Volume : 6, Issue : 1, Year : 2023

Article Page : 16-21

https://doi.org/10.18231/j.sajhp.2023.004

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Abstract

Background: Computed Tomography (CT) chest plays a critical role in early identification & stratification of disease burden and prognostication of COVID-19 disease. We compared in-house created CT based scoring system based on ground glass opacities (G-Score), consolidation (C- Score), and atelectasis A-score (i.e. GCA score) with contemporary CT severity scores & validated it against world health organization (WHO) COVID-19 disease severity scale.
Materials and Methods: Patients confirmed with real time polymerase chain reaction confirmed COVID-19 infections that underwent CT chest investigations as a part of standard of care were recruited. A compound GCA score based on the lung involvement was developed and validated.
Results: Five-hundred patients of which 249 had mild, 220 with moderate, and 31 with severe COVID-19 disease were recruited.
Most involved segments were superior (65%), lateral basal (56%) and posterior basal segments (64%) of right lower lobe and anteromedial (62%) and posterior basal segments (57%) of left lower lobe.
Patchy non-confluent peripheral ground-glass opacities with apicobasal gradient is the most common finding (47%) in mild cases. Bilateral lower lobes were most commonly involved (72%).
In moderate cases ground-glass opacities with consolidation is the predominant finding (82%).
In severe cases ground-glass opacity, consolidation as well as linear platelike atelectasis and reticular opacities may represent with apicobasal gradient (80%).
Conclusion: HRCT Chest has certainly come up as a versatile aid for our war against COVID -19. Firstly it helps to diagnose the pulmonary involvement of the disease and when complimented with a good scoring system furthermore it stratifies the disease burden.

Keywords: HRCT, Lung, Coronavirus, GGO, Consolidation atelectasis

How to cite : Dalal D, Govindwar A, Gangwani G, Panchal M, Gawali V, High resolution computed tomography guided anatomico-pathological scoring system for stratifying and prognosticating pulmonary manifestations of COVID-19. South Asian J Health Prof 2023;6(1):16-21

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