Assigning computed tomography involvement score in COVID-19 patients: prognosis prediction and impact on management

Malpani Dhoot, Nilu; Goenka, Usha; Ghosh, Somali; Jajodia, Surabhi; Chand, Rashmi; Majumdar, Sanjib; Ramasubban, Suresh

OBJECTIVE: Chest CT can provide a simple quantitative assessment of the extent of the parenchymal opacities in COVID-19 patients. In this study, we postulate that CT findings can be used to ascertain the overall disease burden and predict the clinical outcome. METHODS: In this prospective study undertaken from March 28, 2020, until May 20, 2020, 142 patients with CT features suggestive of viral pneumonia, and positive RT-PCR for COVID-19 were enrolled. A dedicated spiral CT scanner was used for all COVID-19 suspects. CT features were reported as typical, indeterminate, or atypical for COVID-19 pneumonia. A CT involvement score (CT-IS) was given to each scan and assigned mild, moderate, or severe category depending on the score range. The patients were followed up for at least 15 days. RESULTS: Ground glass opacity was present in 100% of the patients. There was a significant association between CT-IS and the final outcome of the patients. A statistically significant increasing trend of mortality and requirement of critical medical attention was observed with the rising value of CT-IS in COVID-19. CONCLUSION: The severe CT-IS score group has a high mortality. The CT-IS score could be valuable in predicting clinical outcome and could also be useful in triage of patients needing hospital admission. In situations where healthcare resources are limited, and patient load high, a more careful approach for patients with higher CT-IS scores could be indispensable. ADVANCES IN KNOWLEDGE: CT-IS is a simple quantitative method for assessing the disease burden of COVID-19 cases. It can be invaluable in places with limited resources and high patient load to segregate patients requiring critical medical attention.