COVID-19: HRCT lung pattern, distribution and severity score with clinico-pathological correlation in a tertiary level institution in rural Maharashtra


  • Kumar Snehil Department of Radiodiagnosis, KIMS, Karad, Maharashtra, India
  • Amol S. Bhoite Department of Radiodiagnosis, KIMS, Karad, Maharashtra, India
  • Tamboli Asif Department of Radiodiagnosis, KIMS, Karad, Maharashtra, India
  • Radha R. Bawage Department of Radiodiagnosis, KIMS, Karad, Maharashtra, India
  • Shreya R. Garg Department of Radiodiagnosis, KIMS, Karad, Maharashtra, India
  • Amol A. Gautam Department of Radiodiagnosis, KIMS, Karad, Maharashtra, India
  • Pramod R. Shaha Department of Radiodiagnosis, KIMS, Karad, Maharashtra, India



COVID-19, HRCT, D-dimer, CT severity score


Background: The severe acute respiratory syndrome corona viruses 2 (SARSCoV-2) are enveloped positive sense RNA virus. Most patients of coronavirus disease 2019 (COVID-19) show fever, cough, dyspnoea and myalgia with weakness.

Methods: In this retrospective cross-sectional study 502 patients who were RT-PCR positive for COVID-19 participated in our study after informed consent was taken from all patients, during the period of 3 months between July to September 2020. The study was conducted in Department of Radiodiagnosis at Krishna Institute of Medical Sciences in karad. Each HRCT-Lung scan was evaluated for distribution (central or peripheral); findings (like ground glass opacities, interlobular septal thickening). Every lobe was then allotted CT severity score.

Results: The threshold cut-off value for HRCT severity score was found to be 8. The parameters achieved with this cut-off value were: sensitivity – 100%, specificity- 95.15%, positive predictive value- 85.7%, negative predictive value – 100%. On application of pearson correlation coefficient between HRCT severity score and pathological parameters, it was found that strongest correlation was found to be with D-dimer values (0.833), then with ESR (0.484) and least with N/L (neutrophil/lymphocyte) ratio (0.350).

Conclusions: On imaging, HTCT thorax showed most common involvement to be peripheral, ground glass opacity and crazy paving being most common findings. The most common finding being left and right lower lobe. The ROC curve showed the CT severity score corresponding to clinical severity to be 8. Among pathological parameters, the strongest correlation with CT severity score was found to be with D-dimer.

Author Biographies

Kumar Snehil, Department of Radiodiagnosis, KIMS, Karad, Maharashtra, India

Senior Resident, Department of Radiodiagnosis

Amol S. Bhoite, Department of Radiodiagnosis, KIMS, Karad, Maharashtra, India

Assistant Professor, Department of Radiodiagnosis


Jutzeler CR, Bourguignon L, Weis CV, Tong B, Wong C, Rieck B, et al. Comorbidities, clinical signs and symptoms, laboratory findings, imaging features, treatment strategies, and outcomes in adult and pediatric patients with COVID-19: A systematic review and meta-analysis. medRxiv. 2020.

Li Lq, Huang T, Wang Yq, Wang Zp, Liang Y, Huang Tb, et al. COVID‐19 patients' clinical characteristics, discharge rate, and fatality rate of meta‐analysis. Journal of medical virology. 2020;92(6):577-83.

Ng M-Y, Lee EY, Yang J, Yang F, Li X, Wang H, et al. Imaging profile of the COVID-19 infection: radiologic findings and literature review. Radiology: Cardiothoracic Imaging. 2020;2(1):e200034.

Li K, Wu J, Wu F, Guo D, Chen L, Fang Z, et al. The clinical and chest CT features associated with severe and critical COVID-19 pneumonia. Investigative radiology. 2020;4:20-4.

Tian S, Hu N, Lou J, Chen K, Kang X, Xiang Z, et al. Characteristics of COVID-19 infection in Beijing. Journal of Infection. 2020;8:22-8.

Zhou S, Wang Y, Zhu T, Xia L. CT features of coronavirus disease 2019 (COVID-19) pneumonia in 62 patients in Wuhan, China. American Journal of Roentgenology. 2020;214(6):1287-94.

Salehi S, Abedi A, Balakrishnan S, Gholamrezanezhad A. Coronavirus disease 2019 (COVID-19): a systematic review of imaging findings in 919 patients. American Journal of Roentgenology. 2020:1-7.

Hu Y, Sun J, Dai Z, Deng H, Li X, Huang Q, et al. Prevalence and severity of corona virus disease 2019 (COVID-19): A systematic review and meta-analysis. Journal of Clinical Virology. 2020:104371.

Yao Y, Cao J, Wang Q, Shi Q, Liu K, Luo Z, et al. D-dimer as a biomarker for disease severity and mortality in COVID-19 patients: a case control study. Journal of intensive care. 2020;8(1):1-11.

Chan AS, Rout A. Use of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in COVID-19. Journal of clinical medicine research. 2020;12(7):448.

Jacobi A, Chung M, Bernheim A, Eber C. Portable chest X-ray in coronavirus disease-19 (COVID-19): A pictorial review. Clinical Imaging. 2020;9:12-8.

Smith DL, Grenier J-P, Batte C, Spieler B. A Characteristic Chest Radiographic Pattern in the Setting of COVID-19 Pandemic. Radiology: Cardiothoracic Imaging. 2020;2(5):e200280.

Choi H, Qi X, Yoon SH, Park SJ, Lee KH, Kim JY, et al. Extension of coronavirus disease 2019 (COVID-19) on chest CT and implications for chest radiograph interpretation. Radiology: Cardiothoracic Imaging. 2020;2(2):e200107.

Yang R, Li X, Liu H, Zhen Y, Zhang X, Xiong Q, et al. Chest CT severity score: an imaging tool for assessing severe COVID-19. Radiology: Cardiothoracic Imaging. 2020;2(2):e200047.

Bhalla AS, Jana M, Naranje P, Manchanda S. Role of Chest Radiographs during COVID-19 Pandemic. Annals of the National Academy of Medical Sciences (India). 2020;2:24-8.






Original Research Articles