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; Amit Gupta; Komal Vadgama; Hardik D Desai; Neha Sharma; Komal Shah; Dhigishaba M Jadeja

doi:10.4103/ijri.IJRI_796_20

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

Indian J Radiol Imaging. 2021 Jan;31(Suppl 1):S122-S127. doi: 10.4103/ijri.IJRI_796_20. Epub 2021 Jan 23.

Authors

Kamal Sharma¹, Amit Gupta², Komal Vadgama², Hardik D Desai³, Neha Sharma⁴, Komal Shah⁵, Dhigishaba M Jadeja⁶

Affiliations

¹ U N Mehta Institute of Cardiology and Research Center, Affiliated to B J Medical College, Ahmedabad, Gujarat, India.
² Usmanpura Imaging Center, Ahmedabad, Gujarat, India.
³ Graduate Medical Education, Gujarat Adani Institute of Medical Sciences, Affiliated to K S K V University, Bhuj, Gujarat, India.
⁴ Cardiology Clinic, Ahmedabad, Gujarat, India.
⁵ Indian Institute of Public Health, Gandhinagar, Gujarat, India.
⁶ Gujarat Adani Institute of Medical Sciences, Affiliated to K S K V University, Bhuj, Gujarat, India.

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.