~ 82 ~ International Journal of Radiology and Diagnostic Imaging 2020; 3(3): 82-88 E-ISSN: 2664-4444 P-ISSN: 2664-4436 www.radiologypaper.com IJRDI 2020; 3(3): 82-88 Received: 10-05-2020 Accepted: 12-06-2020 Dr. Vijay Kulshrestha Associate Professor, Department of Radio- Diagnosis, G.S. Medical College and Hospitals, Pilkhuwa, District Hapur, Uttar Pradesh, India Dr. S Kumar Chief Medical Superintendent G.S. Medical College and Hospitals, Pilkhuwa, District Hapur, Uttar Pradesh, India Dr. RS Khurmi Additional Medical Superintendent, G.S. Medical College and Hospitals, Pilkhuwa, District Hapur, Uttar Pradesh, India Dr. Atul Agarwal Associate Professor, Department of Surgery G.S. Medical College and Hospitals, Pilkhuwa, District Hapur, Uttar Pradesh, India Corresponding author Dr. Vijay Kulshrestha Associate Professor, Department of Radio- Diagnosis, G.S. Medical College and Hospitals, Pilkhuwa, District Hapur, Uttar Pradesh, India Role of imaging (X-ray & HRCT) chest in diagnosis, management and prognosis of COVID-19 pneumonia Dr. Vijay Kulshrestha, Dr. S Kumar, Dr. RS Khurmi and Dr. Atul Agarwal DOI: http://dx.doi.org/10.33545/26644436.2020.v3.i3b.120 Abstract Objective: Our main aim is to have accurate diagnosis using chest x-ray as preliminary investigation in a developing country like India. However HRCT chest is indicated for moderate, severe cases & follow up of patient. The radiological findings are correlated with RT-PCR test & clinical features of covid-19 pneumonia cases. The case fatality rate in India has declined to 1.94% due to increase in testing rate, taking precautions like mask wearing & sanitizing hands frequently, maintaining social distancing & increase number of dedicated covid hospital in each district of India. Methods: The clinical features, laboratory & radiological findings were analyzed in 250 covid-19 patients and confirmed by RT-PCR, from 10 th May 2020 to 31 th August 2020, admitted in our dedicated covid-19 hospitals of G.S. Medical College, Hapur, NCR, India. Results: The common clinically findings reported in covid-19 pneumonia cases were fever, sore throat, cough, breathlessness, Myalgia, loss of smell & taste. The initial investigation x-ray chest were done of all patients, 45% patients showed ground glass opacities as haziness. Out of the 250 patients, 32% patients showed bilateral patchy opacities involving peripheral lung. While 68% patients showed bilateral basal lung involvement. 62% patients revealed peripherally lesions in Sub pleural area & bilateral basal region. The CT. lesions were located both in peripheral & central location (32%). C.T severity scoring (CTSS) is strongly recommended to assess progression or regression of GGO’s & consolidative lesions, at the time of admission & follow up. C.T findings are seen as ground glass opacities, (uni / bilateral), presence of nodules, round & cystic changes, consolidation, reticular pattern, crazy- paving pattern, pleural thickening / effusion, lymphadenopathy, bronchiolectasis. On HRCT CHEST, 78% patients were reported as multi focal, multiple ground glass opacities located in Sub pleural, mid & basal region. 31% patients showed uni or bilateral patchy consolidation.52% showed bilateral patchy peripheral location. C.T. severity scores of I.C.U patients were found higher as compare to patients from isolation ward. Conclusion: X-ray chest plays an initial role in level 1 & level 2 cases with mild findings while HRCT chest is recommended in moderately affected & ICU patients (severe) cases with or without co- morbidities like diabetes, hypertension, COPD, > 60 yrs of age with positive findings in x ray chest involving bilateral 4 or 5 lobes and having strong clinical features. - There is crucial role of HRCT chest in diagnosis of covid-19 pneumonia, particularly for those patients, who have a negative RT-PCR initially. - The important role of HRCT chest in diagnosis, severity scoring and for Management of patients, in Prognosis & follow- up. Keywords: Covid-19 pneumonia, HRCT (High resolution computed tomography), GGO. (Ground glass opacities), consolidation, chest radiography. C T Severity score, ARDS (Acute respiratory distress syndrome) Introduction There was reported a highly infection flu like illness disease in Wuhan city in Hubei province of China in the month of December 2019 [1] . Later on the case of this disease found to be noble corona virus disease 2019 or SARS-covid- 2 [2] . On 11 th March, this disease is designated as covid-19 by W.H.O & declared as a pandemic. After due course of time, disease spread rapidly in most of the countries of the world, causing a global health emergency [3] .