Abstract

Objectives: The country Nepal was badly hit in second phase of epidemic due to highly transmitted Delta and Delta plus variant. The aim of this study was to investigate the different characteristics of chest HRCT, X-Ray and abnormalities in laboratory parameters of COVID-19 patients during second phase of epidemic.

Methods: COVID-19 Patients were admitted to COVID ward, Bharatpur Cancer Hospital. Patients underwent for Chest X-Ray or HRCT and laboratory tests for further evaluation were retrospectively analyzed. Patient without pneumonia were excluded from study. Statistical analysis was performed to evaluate the characteristics of Group-A (laboratory parameters with HRCT) and Group-B (laboratory parameters with X-Ray).

Results: A total number of 116 patients (72 males and 44 females, age range 3-90 years) were admitted to COVID ward. A total number of 67 patients in which 55 patients (Group A) and 12 patients (Group B) were included in the study. Different laboratory test were evaluated for all those 67 patients. In our study, typical and atypical appearances of HRCT was Ground-Glass Opacities (GGO), Crazy Paving, Consolidation, Bronchiectasis, Multifocal GGO, Bronchiectasis, Collapse and Fibrotic. In group A, CT severity of 11, 18 and 26 were mild, moderate and severe respectively. In Group B, 6 patients were mild and 6 were moderate. There were alteration in laboratory tests i.e., platelets, WBC, neutrophil, lymphocytes, eosinophil, monocyte, CRP, Glucose, Bilirubin Total, Bilirubin Direct, ALT, AST, and LDH were 43%, 40%, 85%, 89%, 42%, 74%, 95%, 61%, 10.9%, 14.5%, 85%, 63%, and 100% respectively.

Conclusion: There were mostly typical Ground-Glass-Opacities (GGO) appearances in HRCT chest with some atypical appearances. There was elevation in Neutrophil, CRP, Glucose, ALT, AST, and LDH whereas low counts in platelets, WBC, lymphocyte, eosinophil, and monocyte. Statistical correlation was found between laboratory analyses and amount of damaged lung. We concluded that symptomatic patients even with negative RT-PCR should be considered as COVID-19 patients if CT and biochemical tests are positive.

Keywords: COVID-19; SARS-CoV-2; RT-PCR; Biochemical Laboratory test