 Hello everyone, myself Dr. Shubhanga Meena, junior resident at Department of Rated Diagnosis Government Medical College, Kota. Today, I'll be presenting my paper titled, High Resolution Computed Tomography Findings in COVID-19 Patients, Having CT Severeity Score of More Than 10 at 6 Month Follow-up Scan After Recovery. Introduction, novel coronavirus disease or popularly known as COVID-2019 is an infectious disease caused by severe acute respiratory syndrome coronavirus 2. HRCT plays a crucial role in the diagnosis and follow-up of patients with COVID-19 pneumonia. Numerous studies have documented radiographic changes in the acute course of COVID-19 which range from mild to severe cases. Recent publications have found that approximately 94% of hospitalised patients have persistent lung parankimal findings on the testarct CT scans. In addition, a study conducted by Liu et al. reported that lung opacities in 53% of patients with mild COVID-19 result with no adverse equally within three weeks after discharge. Data from previous coronavirus infections, that is severe acute respiratory syndrome and Middle East respiratory syndrome, suggest that there may be substantial fibrotic consequences in patients with COVID-19. However, little is known about the long-term lung changes after COVID-19 infection. Ames and objective of our study were to determine the completed tomography findings in the COVID survivors at six months' follow-up CT scan, to study the potential acute and chronic post-COVID chest complications like lung fibrosis, and to determine the spectrum of chest-computed tomography findings in COVID-19 disease. Materials and Methods Our study design was a prospective observational study. The duration of study was of one year, starting from January 1, 2022 to December 31, 2022. Study population comprised of all the patients referred to Department of Radio Diagnosis for follow-up CT scan after COVID-19 infection, positive report on RT-PCR, and a raw rapid antigen test six months back in Government Medical College and Associated Group of Hospitals Quota, after obtaining informed written consent. We considered 100 cases who fulfilled our selection criteria during the study period. Coming to the inclusion criteria of the study, all the patients of age more than 18 years diagnosed as COVID-positive by RT-PCR and a raw rapid antigen test six months before. Patients who were having CT severity score of more than 10, and patients fulfilling the above criteria consenting to participate in the study. The exclusion criteria of the study included patients having CT severity score of less than 10, patients of age less than 18 years, patients who did not give consent to participate in the study, and pregnant females. Following approval by the Ethical Committee of the Institute, detailed information about the study was explained to the patients found eligible for inclusion in the study. Informed consent was taken from all of them. Demographic profiles of the patients were noted and complete details about the clinical diagnosis and laboratory diagnosis was noted in the study pro forma. Follow-up HR CT was done at New Medical College and Hospital Quota, Rajasthan, and patient questionnaires were completed during each screening visit. Now coming to the results of our study, table one shows distribution of patient according to age more than one fourth of the patients that is about 29% of the patients were between 50 to 60 years, followed by 22% of patients between 60 to 70 years, 19% of patients were between 30 to 40 years, 12% of patients were between 40 to 50 years, and 9% of patients were between 20 to 30 years and those above 70 years. Chart one shows distribution of patients according to gender. Majority of the patients were males that is about 70% of the patients. Chart two shows the distribution of patients according to mechanical ventilation requirement during COVID infection. Total 23 of patients who were serious got mechanical ventilation out of which 21 got non-invasive and two got invasive mechanical ventilation. Table two shows the distribution of patients according to co-morbidities. 11% of the patients had diabetes, 34% of the patient had hypertension, 26% of patients had acute respiratory distress syndrome before COVID-19 infection, and 16% of patients had other respiratory problems. Table three shows the distribution of patients according to spectrum of chest CT findings at six months follow-up scan. Ground class opacities was found in 72% of the patients, followed by traction bronchitis, septal thickening, and reticulations in 30% of the patients. Consolidation was seen in about 10% of cases. Plural effusion was seen in about 12% of the patients, and 11% of patients showed midiastinal lymphedinopathy. Table four shows the association between admission status at the time of COVID infection and post-COVID CT findings. 29 out of 100 patients who were hospitalized had traction bronchitis, reticulation, and septal thickening in their follow-up CT scans. Four patients were having honey combing, and one had reverse halosine. Table five shows the association between mechanical ventilation required during COVID infection and post-COVID CT findings. Total of 21 patients were on non-invasive mechanical ventilation, out of which 19 patients showed traction bronchitis, reticulations, and septal thickening in their follow-up CT scan. Three patients were having honey combing, and one patient showed reverse halosine. Two patients which required invasive mechanical ventilation showed traction bronchitis, reticulations, and septal thickening on their follow-up CT scan. Table six shows the association between co-morbidities and post-COVID CT findings. Out of 100 patients, 8 patients had diabetes, 18 patients who had hypertension, 13 patients with respiratory problems, and 22 patients with acute respiratory distress syndrome were found to have post-COVID findings on CT, like traction bronchitis, reticulations, and septal thickening. One diabetic and two hypertensive patients had honey combing, and three diabetic patients had reverse halosine in their follow-up CT scan. Coming to the illustrative cases, image A of case one is an axial HR CT chest image in a YAM patient with severe COVID-19 pneumonia, showing extensive ground-glass opacities with septal thickening. Image B of case one is an axial HR CT chest image after six months, showing complete resolution of the previous abnormalities. Image A of case two is an axial HR CT chest image in a patient with severe COVID-19 pneumonia, showing extensive ground-glass opacities involving bilateral lung parankaima with septal thickening. Image B of case two is HR CT chest image after six months, showing interlobular septal thickening, reticulations, and pre-dominantly in the posterior basal distribution. Image A of case three is an axial HR CT chest image in post-COVID patients showing areas of honey combing with interlobular septal thickening, reticulations, and ground-glass opacities. Image B of case three is HR CT chest image of the same patient showing areas of honey combing, traction bronchitis, and interstitial thickening. Image A of case four is an axial HR CT chest image in post-COVID patient with emphysema, showing emphysemitis changes with bulla formation, honey combing, traction bronchitis, and interstitial thickening. Image B of case four is of the same patient showing honey combing, interlobular septal thickening, and reticulations in bilateral lung fields. Now coming to discussion. In our study, six months follow-up HR CT scan was completely normal in 28% of the patients. Ground-glass opacities was found in 72% of patients in our study and consolidation with ground-glass opacities was found in about 10% of the patients. The scan in which ground-glass opacities was the only finding were mainly young patients or patients of age less than 50 years. 30 out of 100 participants who recovered from severe COVID-19 pneumonia developed fibrotic-like changes that distraction bronchitis, reticulation, and septal thickening in the lung within six months. Honey combing was found in 5% of patients and reverse halo sign was found in 3% of total patients. Patients with age more than 50 years who were hospitalized and on mechanical ventilation and with comorbidities like diabetes and hypertension, a total chest CT score of 18 or greater, on initial CT scans were independent predictors of the subsequent development of fibrotic-like changes in the lungs after six-month follow-up. Patients with COVID score of more than 15 at the time of COVID infection were found to have more lung fibrotic-like changes. Conclusion, follow-up CT scans obtained within six months of disease onset showed fibrotic-like changes in the lung in approximately one-third of patients who survived severe COVID-19 pneumonia. These patients were older and had more severe disease during the acute phase. The young patients showed normal follow-up scans or only ground-glass opacities. However, the long-term lung sequelae of these CT findings are still largely unknown and this report serves as a basis for new prospective large-scale long-term investigations analyzing these high-risk patients. Thank you.