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Objective: To study the HRCT chest findings in patients undergoing cardiac interventions during COVID-19 era. Study Design: Cross sectional analytical study. Place and Duration of Study: Armed Forces Institute of Cardiology & National Institute of Heart Disease (AFIC/NIHD) Rawalpindi, from Apr 2020 to May 2020. Methodology: All the admitted cardiac patients who were to undergo any invasive cardiac intervention underwent plain HRCT chest and polymerase chain Reaction (PCR) for SARS-CoV-2 simultaneously. One hundred and ten patients were studied. We analyzed preexisting respiratory illnesses, clinical, echocardiographic and radiological features. Data recording, storage, assessment and analysis was done by using SPSS-21. Results: Our study included 110 patients (87 Male, 23 Female, median age 52 Years). Common reasons for admission were coronary angiography 43 (39.1%), acute Left Ventricular Failure (LVF) 30 (27.3%), Percutaneous Coronary Intervention (PCI) 13 (11.8%) and chest pain evaluation 10 (9.1%). Cardiomegaly (29.1%) followed by consolidation (9.1%) were commonest radiological finding. Two third patients had abnormal HRCT chest but only few had radiological findings either suspicious (6.4%) or indeterminate (11.8%) for COVID-19. Respiratoy symptoms, positive PCR for COVID-19 and severe Left ventricular dysfunctions were correlated with abnormal HRCT findings, correlation being statistically significant (p-value <0.05). Conclusion: HRCT chest is a non-invasive and highly sensitive imaging modality, which can rapidly help in identifying, and isolating suspected cases of novel corona virus as well as in diagnosing unknown pre-existing lung diseases in cardiac patients.

Objective: To assess chest x-ray appearance of patients with positive RT-PCR test for SARS-Cov-2 and utilize modified RALE score for severity assessment of chest x-ray findings for correlation with clinical spectrum of disease. Study Design: Prospective observational study. Place and Duration of Study: Armed Forces Institute of Radiology & Imaging, Pak Emirates Military Hospital, Rawalpindi, from Apr 2020 to May 2020. Methodology: First 1000 consecutive chest x-rays of COVID-19 patients with RT-PCR confirmation at our setup were analyzed. Positive chest x-rays were assessed for consolidation, ground glass opacities and location of involvement. A severity index using modified RALE score was calculated for each & both lungs. Results: 932 patients were males and 68 were females with an average age of 40.77 years ± 13.58. Out of 1000 patients, 759 (75.9%) had normal chest x-rays. 241 patients had positive findings, ground glass opacities being the most frequent feature 211 (87.6%) showing peripheral 219 (90.9%), bilateral 182 (75.5%) and lower zone predominance 221 (91.7%). The optimal modified RALE score threshold for recognizing severe disease was 4.5 (area under curve, 0.943), with 79.2% sensitivity and 96.3% specificity. Conclusion: COVID-19 patients with positive chest x-ray findings frequently showed ground glass opacities with bilateral lower zone involvement in peripheral distribution. Modified RALE score can be used for objective evaluation of clinically severe patients.