Chest Radiograph Findings in Critical and Non-Critical Patients with Covid-19: A Study from Pakistan

Abstract

Objective: To find out the common patterns of COVID-19 infection manifestations on chest radiographs and to compare the findings between critical and stable admitted patients.
Methods: This retrospective study was conducted in Department of Radiology Mayo Hospital, Lahore from 1st July 2020 to 31 December 2020. PACS database was searched for chest radiographs of patients with  confirmed COVID-19 infection. The radiographs which fulfilled the inclusion and exclusion criteria were then analyzed by two qualified and experienced radiologists for presence and type of abnormality, zonal distribution, peripheral verses central distribution, unilaterality or bilaterality of findings and presence of
ancillary findings. The findings were then compared between patients admitted in ICU and those in non-ICU settings.
Results: The most common abnormality was consolidation (53.1%) in both critical and non-critical patients, followed by ground glass opacities (32.4%). The findings were seen mostly in lower zone and bilaterally in both subsets. The findings were seen predominantly in peripheral location overall (55.0%) and in non-critical patients (63.3%). However, they were mostly randomly distributed in critical patients (50.9%). Ancillary findings were seen in a minority of patients (4.6%), more so in the critical subgroup. Overall the most
common pattern in both critical and non-critical patients was bilateral, peripheral, lower zone consolidations.
Conclusion: Chest radiograph is fairly capable of detecting abnormalities associated with COVID-19 infection in admitted patients particularly critical ones with bilateral, peripheral, lower zone consolidations and ground glassing being the hallmark of COVID-19 infection.