HRCT MANIFESTATIONS OF COVID-19 IN PATIENTS WITH DIABETES MELLITUS: A CASE CONTROL STUDY

Dr. B. K. Duara, Dr. Sushma C. Biradar, Dr. Rahul C. M.*, Dr. Bhaskar Das, and Dr. Subhosree Dey

ABSTRACT

Context: High Resolution Computed tomography findings of COVID-19 patients. Aims: To collect information regarding the role of High Resolution CTs, findings and manifestations in patients of COVID 19 disease with Diabetes Mellitus and correlate the severity of the disease with COVID-19 patients without diabetes mellitus. Materials and Methods: 100 patients of COVID 19 disease were included in the study between October 2020 to March 2021. (32 diabetic and 68 non diabetic). The analysis revealed important conclusions regarding the common findings in HRCT in patients of covid 19 disease, with and without diabetes mellitus. Diabetes Mellitus has been identified as an important co-morbidity in COVID-19 disease. The comparison of HRCT findings between COVID-19 patients with or without Diabetes Mellitus revealed some important facts. Statistical Analysis Used: IBM SPSS Statistics Subscription software (IBM, New York, USA). Results: A total of 100 patients were included in the study. Cough (61%, 61/100) and fever (54%, 54/100) were the most frequent symptoms. 78% (78/100) patients revealed COVID-19 pneumonia-like abnormalities on HRCT. Majority of patients with Diabetes mellitus (93.7%, 30/32) had more abnormal HRCT findings compared to patients without diabetes (70%, 48/68). There was a predominant bilateral lung involvement (84.6%, 66/78) with most common findings being GGO (83.3%, 65/78), Interlobular septal thickening (69%),Crazy paving pattern (46.2%), consolidation (32/78, 41%), predominantly in a subpleural (78.2%, 61/78) and peripheral distribution (89.7%, 70/78), involving mainly the lower lobes( Left lower lobe in 87.2% and right lower lobe in 86% ). Findings were seen more in the diabetic group as compared to the non diabetic group. The average duration of hospital stay for the cases in our study was 17 days, however the duration of stay among diabetics was 25 days and among non-diabetics was 9 days. Average CT severity score of diabetic patients were higher (22/25) as compared to non diabetic patients (17/25). After 14 days of discharge, follow up scan revealed persistent GGO predominantly in diabetic patients (11/14, 78.5 %) compared to non- diabetic patients (10/25, 25%). Conclusions: We believe that the results of this study will help to understand and to identify the role of imaging techniques like HRCT in the evaluation and diagnosis of diabetic patients, their needs and predispositions in relation to the COVID-19 pandemic. The results of this study may very well inform the development of an overall standardized system for reporting of HRCT in relation to diabetes mellitus for diagnosis and imaging protocols in pandemic conditions.

Keywords: COVID-19, Diabetes Mellitus, HRCT, Ground Glass Opacities, Interlobar septal thickening, Crazy Paving.