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Original Research
A study of the chest imaging findings of adult patients with COVID-19 on admission to a tertiary hospital in Johannesburg, South Africa
Submitted: 18 May 2022 | Published: 30 August 2022
About the author(s)
Ashleigh A. Ord, Department of Diagnostic Radiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaJarrod Zamparini, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and, Department of Internal Medicine, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
Liam Lorentz, Department of Radiology, Capital Radiology, Pretoria, South Africa
Ashesh Ranchod, Department of Diagnostic Radiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and, Department of Radiology, NRS Incorporated Netcare N17 Private Hospital, Springs, South Africa
Halvani Moodley, Department of Diagnostic Radiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and, Department of Diagnostic Radiology, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
Abstract
Background: South Africa has experienced multiple waves of the coronavirus disease 2019 (COVID-19) with little research documenting chest imaging features in an human immunodeficiency virus (HIV) and tuberculosis (TB) endemic region.
Objectives: Describe the chest imaging features, demographics and clinical characteristics of COVID-19 in an urban population.
Method: Retrospective, cross-sectional, review of chest radiographs and computed tomographies (CTs) of adults admitted to a tertiary hospital with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, between 01 May 2020 and 30 June 2020. Imaging was reviewed by three radiologists. Clinical parameters and laboratory data were analysed.
Results: A total of 113 adult patients with a mean age of 46 years and 10 months were included. A total of 113 chest radiographs and six CTs were read. Nineteen patients were HIV-positive (16.8%), 40 were hypertensive and diabetic (35.4%), respectively, and one had TB (0.9%). Common symptoms included cough (n = 69; 61.6%), dyspnoea (n = 60; 53.1%) and fever (n = 46; 40.7%). Lower zone predominant ground glass opacities (58.4%) and consolidation (29.2%) were most frequent on chest radiographs. The right lower lobe was most involved (46.9% ground glass opacities and 17.7% consolidation), with relative sparing of the left upper lobe. Bilateral ground glass opacities (66.7%) were most common on CT. Among the HIV-positive, ground glass opacities and consolidation were less common than in HIV-negative or unknown patients (p = 0.037 and p = 0.05, respectively).
Conclusion: COVID-19 in South Africa has similar chest imaging findings to those documented globally, with some differences between HIV-positive and HIV-negative or unknown patients. The authors corroborate relative sparing of the left upper lobe; however, further research is required to validate this currently unique local finding.
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