The imaging procedures play important role in the COVID-19 pandemic when the question of assessment of suspected cases and determination of the course of the disease arises. Analysing chest X-ray findings revealed lower sensitivity for COVID-19-related lung shadowing seen in 25 to 69% of cases. X-Ray imaging helps us to identify the disease correctly as well as the prognosis of the disease condition. A significant percentage of patients with COVID-19 have normal chest x-rays. The x-rays are not recommended as the only way to diagnose COVID-19, they may be appropriate on a case-by-case basis. A chest x-ray cannot accurately distinguish between COVID-19 and other respiratory infections, like seasonal flu but some of the changes seen in the case of COVID-19 are below:

The most common changes in the lung include:
• Consolidation is present- It is also known as accumulations of fluid and tissue in pulmonary alveoli preventing gas exchange. It can be multifocal, patchy, or segmental with subpleural location or along broncho vascular bundles. The accumulation of the fluid in pulmonary alveoli is dependent upon case to case and severity of the disease condition.
• Reticular pattern may be seen- In this condition there is the thickening of the pulmonary interstitial structures as interlobular septa and intralobular lines with linear opacities is seen.
• Bronchus deformation Airway changes or bronchiectasis and thickening of bronchial wall thickening is seen in some cases and also inflammatory changes of the bronchial wall leading to obstruction and subsequent destruction of the bronchial wall. The mainly affected are of COVID-19 patients is peripheral and lower areas of the lungs.
• Ground glass opacity is seen.
• Presence of nodular shadowing.
• In the case of children’s X-ray examinations can be considered if a child suspected with COVID-19 has moderate to severe symptoms of acute respiratory disease.
• Pathological air containing spaces- The small air spaces within the lung it can be due to pathological dilatation or air spaces or due to resorption of consolidation.
• Fibrosis- Lung fibrosis is also present in X-ray as well as Ct scan imaging.

Extrapulmonary findings:
• Pleural changes – The pleural thickening was reported in COVID-19 with a higher incidence.
• Pericardial effusion – The pericardial effusion is also seen in some cases of COVID-19. And severe inflammatory changes may be seen in the pericardium.

The CT-scan can be helpful for determining a plan of care for a patient. The CT findings in COVID-19 are variable and it doesn’t confirm the diagnose of COVID-19.

The initial stage of CT-findings in COVID-19 cases shows bilateral and multi-lobar ground-glass opacities with a peripheral or posterior distribution, mainly in the lower lobes and less frequently in the middle lobe.

The septal thickening, pleural thickening, bronchiectasis, and subpleural involvement are some of the less common findings, mainly in the later stages of the disease.

In some advanced cases the pleural effusion, pericardial effusion, lymphadenopathy, and pneumothorax are seen.

In advanced cases, the CT-scan imaging shows:
1) Heterogeneous widespread with thickening of the walls.
2) Pathological air containing spaces/ Air Bronchogram- the small air spaces within the lung it can be due to pathological dilatation or air spaces or due to resorption of consolidation.
3) Pleural effusion
The pleural effusion is also seen in some cases of COVID-19. And severe inflammatory changes may be seen in lining of lungs.
4)Fibrosis Lung fibrosis is also present in CT scan as well as X-ray imaging. In this condition the replacement of cells by scar tissue in the healing process of chronic pulmonary inflammation.
5)Bronchus distortion