Spectrum of HRCT Scan Chest Findings in COVID-19 Patients as Categorized by Modified CO-RADS Classification

Objectives: The Dutch Radiological Society developed CO-RADS classification, a system for the classification of CT scan chest findings among suspected COVID-19 patients. However due to some important issues it was modified by authors and then applied on our study population. The objective was to study the spectrum of lungs involvement as concluded by HRCT scan chest finding and classifying it using the “Modified CO-RADS classification”

Methods: This cross-sectional study was conducted jointly by the departments of Medicine and Radiology, JPMC from January 16, 2021 to April 30, 2021. This study includes suspected cases of COVID-19 patients aged between 18-80 years who came for HRCT chest. Their data variables were recorded. HRCT findings were classified using “Modified CO-RADS classification”. Patients’ results of real time PCR for COVID-19 were also followed.

Results: A total of 78 patients presented to the study department during this study period. Of them 85.8% were male (n=67) and 14.2% were female (n=11). Out of the 78 patients, 58 were tested positive for COVID-19 on first RT-PCR on follow up. Among positive two patients (3.4%) had CO-RADS-1, 4 patients (7%) had CO-RADS-2, 19 patients (32.75%) had CO-RADS-3, 21 patients (36.2%) had CO-RADS-4 while 12 patients (20.7%) had CO-RADS-5 category. (CO-RAD-6 category was omitted). Of the patient who had negative results on RT-PCR, five patients had CO-RADS-4 while three patients had CO-RADS-5. On repeat RT-PCR all (8/8) patients of category IV and V proved Covid-19 positive.

Conclusion: HRCT scan chest can be used for quicker diagnosis of COVID-19 patients in patients with respiratory complaints in whom prompt diagnosis is required and when RT-PCR investigation process would be taking prolonged time due to over burden during pandemic situation. “CO-RADS classification after modification” proved more effective communicative tool to label and understand the severity of lung involvement in Covid-19 disease.