Title: Imaging trend and disease course in admitted COVID-19 patients

Abstract

Background: Coronavirus Disease 2019 (COVID-19)- a global pandemic declared by the World Health Organization (WHO) in March 11, 2020, for a lower respiratory tract illness of unknown origin that started as an outbreak in Wuhan City of China in December 2019- was found to be a novel strain of corona virus as determined on bronchoalveolar lavage of the affected patients. The disease is still prevalent in whole world, greatly affecting not only the healthcare systems but also severely impacting on world’s economy, travel, trade and behaviours of mankind. Objectives: To describe radiographic imaging findings and disease course in admitted COVID-19 patients. Methods: This retrospective study was carried in the Radiology Department, King Fahad Military Medical Complex, Dhahran between March to August 2020 (6 months). All laboratory confirmed COVID-19 admitted cases were evaluated for their symptoms, duration of hospital stays (in a ward or intensive care unit [ICU]), and imaging findings (groundglass opacity [GGO], air-space shadowing/ consolidation, and others such as atelectasis, reticulation, peribronchovascular thickening, lymphadenopathy and pleural effusion) on chest radiograph (CXR) and computed tomography (CT) studies. Cavitation, nodularity, bronchiectasis, and embolism detected on CT scans were considered as complications. Disease course in terms of recovery (radiographic regression or resolution of findings), worsening (shifting from ward to ICU), and unfavourable outcome (persistent ICU stay or death) were recorded. Chi-square test was used to determine association. Results: Out of 106 patients, majority were males (n=82, 77.4%). Forty-six patients (43.3%) had abnormal imaging with mostly peripheral GGO (56.5%), followed by consolidations (34.7%), and others (26%). Complications were detected in 6 ICU patients. All patients with unfavourable outcomes were above 60 years having comorbidities or complications (p less than 0.0005). Conclusions: Coronavirus disease 2019 is seen mostly affecting males, with peripheral opacities as common imaging findings. Elderly patients with co-morbidities may show unfavourable outcomes.