Dr Md Nazrul Islam, Associate Professor (Neuro-Radiology), Department of Radiology and Imaging, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh; E-mail:
Mymensingh Med J. 2021 Jan;30(1):182-188.
The objective of the study was to investigate and quantify the severity of COVID-19 infection by high resolution computed tomography (CT) of chest and to determine its relationship with clinical parameters. This study also aimed to see CT changes with clinical recovery or progression of disease. This cross sectional study was performed from July 20 to August 20, 2020, where both chest HRCT and clinical features were included in laboratory confirmed COVID-19, 100 patients, attending the depertment of Radiology & Imaging, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. This study included clinical symptoms, comorbidities of patients, HRCT chest characteristics, CT severity score. After collection of all required data and careful medical chest review, the clinical data of laboratory confirmed patients was compiled and tabulated. In this study group out of 100 patients, most of the patients were in 5th & 6th dacades with a mean age of 53.7 years. In this study out of 100 patients 72% were male and 28% were female with an average sex ratio of male : female being 2.5:1. Prevalance of various clinical presentation in this study sample population distributed as fever in 76% cough in 77.4%, shortness of breath in 55%, sore throat in 17% were the most common clinical manifestations while a few patients (13.2%) also had other symptoms like headache, chest tightnes, anosmia and diarrhoea. Major comorbid conditions were diabets mellitus, hypertension, bronchial asthma and Chronic kidney disease (CKD). Patient with comorbid disease, especially if multiple had higher symptomatic presentation. Out of 100 patients 75.5% patient had co-morbidity where as 24.5% ptaients did not have any co-existing disease. According to HRCT imaging severity score the lung pathological changes were evaluated, when typical covid findings in 80%, intermediate in 10%, atypical in 2% and normal chest CT findings in 8% patients. Symptomatic presentation had found higher (85.21%) who had CT severity index >15/25 while sympotomatic presentation lesser (14.79%) who had CT severity index <15/25. CT severity index of 1-5 was seen in 20(21.73%) patients, 6-10 in 38(41.30%) patients, 11-15 in 22(23.91% patients, 16-20 in 10(10.86%) patients and 21-25 in 2(2.17%). As positive CT findings were more prominent in symptomatic and co-morbid patients HRCT chest in COVID-19 patient had a major diagnostic and prognostic importance. Clinical symptoms of patients directly correlated with CT severity score. Therefore, CT imaging was found to be useful in predicting clinical recovery of patient or progression of disease.
本研究旨在通过高分辨率胸部计算机断层扫描（CT）调查和量化 COVID-19 感染的严重程度，并确定其与临床参数的关系。本研究还旨在观察 CT 随疾病临床康复或进展的变化。这项横断面研究于 2020 年 7 月 20 日至 8 月 20 日进行，包括实验室确诊的 COVID-19 患者的胸部 HRCT 和临床特征，共纳入 100 名患者，他们均在孟加拉国达卡的 Bangabandhu Sheikh Mujib 医科大学放射科和影像科就诊。本研究包括患者的临床症状、合并症、HRCT 胸部特征和 CT 严重程度评分。收集所有必需的数据并仔细审查医学胸部后，将实验室确诊患者的临床数据进行编译和制表。在该研究组的 100 名患者中，大多数患者处于第 5 和第 6 个十年，平均年龄为 53.7 岁。在这项研究中，100 名患者中有 72%是男性，28%是女性，平均性别比为男性：女性为 2.5:1。本研究样本人群中各种临床表现的分布情况为：发热占 76%、咳嗽占 77.4%、呼吸急促占 55%、咽痛占 17%，是最常见的临床表现，而少数患者（13.2%）还存在其他症状，如头痛、胸痛、嗅觉丧失和腹泻。主要合并症包括糖尿病、高血压、支气管哮喘和慢性肾脏病（CKD）。患有合并症的患者，尤其是患有多种合并症的患者，症状表现更为严重。在 100 名患者中，75.5%的患者有合并症，而 24.5%的患者没有任何合并症。根据 HRCT 成像严重程度评分评估肺部病理变化，80%的患者存在典型的新冠病毒感染，10%的患者为中度，2%的患者为非典型，8%的患者为正常胸部 CT 表现。有症状表现的患者（85.21%）CT 严重指数>15/25的比例更高，而无症状表现的患者（14.79%）CT 严重指数<15/25。20 名患者（21.73%）的 CT 严重指数为 1-5，38 名患者（41.30%）为 6-10，22 名患者（23.91%）为 11-15，10 名患者（10.86%）为 16-20，2 名患者（2.17%）为 21-25。由于阳性 CT 发现多见于有症状和合并症的患者，因此 HRCT 胸部在 COVID-19 患者中的诊断和预后具有重要意义。患者的临床症状与 CT 严重程度评分直接相关。因此，CT 成像有助于预测患者的临床康复或疾病进展。
