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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2021; 31(S 01): S122-S127
DOI: 10.4103/ijri.IJRI_796_20
Original Article

Demographic and clinico-radiological profile on High-Resolution Computerized Tomography (HRCT) thorax in mild or asymptomatic clinically suspected COVID-19 patients in high-endemicity area of India—Can HRCT be the first screening tool? —The DECRYPTION study

Kamal Sharma
U N Mehta Institute of Cardiology and Research Center, Affiliated to B J Medical College, Ahmedabad, Gujarat, India
,
Amit Gupta
Usmanpura Imaging Center, Ahmedabad, Gujarat, India
,
Komal Vadgama
Usmanpura Imaging Center, Ahmedabad, Gujarat, India
,
Hardik D Desai
Graduate Medical Education, Gujarat Adani Institute of Medical Sciences, Affiliated to K S K V University, Bhuj, Gujarat, India
,
Neha Sharma
Cardiology Clinic, Ahmedabad, Gujarat, India
,
Komal Shah
Indian Institute of Public Health, Gandhinagar, Gujarat, India
,
Dhigishaba M Jadeja
Gujarat Adani Institute of Medical Sciences, Affiliated to K S K V University, Bhuj, Gujarat, India
› Author Affiliations
Financial support and sponsorship Nil.
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Abstract

Background: With COVID-19 cases rising, despite CT chest being of value in diagnosis and prognostication in COVID-19, its role in mild or asymptomatic suspected COVID-19, before RT-PCR test is lacking. Method: This is a retrospective observational study involving asymptomatic or mildly symptomatic clinically suspected COVID-19 infection in a high endemicity area. Of 2532 HRCT chest database, 376 eligible cases were analyzed for clinico-radiological correlation for CT findings based CORADS and CT severity score between positive vs negative group. Results: Of 376, 186 (48.46%) had COVID-19 features on HRCT in mild and asymptomatic suspected patients. 98 (26.06%) had CO-RARDS - 5, 88 (23.40%) had CO-RADS - 4. 48 (12.76%), 128 (34.04%), 14 (3.72%) had CO-RADS score of 3,2,1, respectively. Positive CT findings were more likely beyond 3 days of symptoms compared to those presenting earlier {days: (Mean) 4.2 vs 2.76} Positive CT was significantly associated with patients with anosmia and dyspnea. The common presenting symptoms were Fever 196 (52.12%) and followed by sore throat in 173 (46.01%). The common HRCT findings were Ground glass opacity (GGO) (74.60%), followed by Lymphadenopathy (LN) (27.92%). LN which was more prevalent in symptomatic patients {99/343 (28.86%) vs {6/33 (18.18%)} asymptomatics (P: 0.04)}. Consolidation was significantly more in asymptomatics with COPD (P: 0.004). 6 (3.22%) patients had CT score >17/25. Conclusion: Chest HRCT picked 48.46% positive cases in mildly symptomatic and asymptomatic patients of which 3.22% had severe involvement (>17). Being a noninvasive, rapid, sensitive, low risk of cross infection with high reproducibility, chest CT is worth evaluating as screening modality even in asymptomatic and mildly symptomatic clinically suspected COVID-19.

Keywords

COVID-19 - high resolution CT - sars-cov-2 - screening


Publication History

Received: 26 September 2020

Accepted: 02 January 2021

Article published online:
13 July 2021

© 2021. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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