Predictors of the chest CT score in COVID-19 patients: a cross-sectional study

Abstract

Background Since the COVID-19 outbreak, pulmonary involvement was one of the most significant concerns in assessing patients. In the current study, we evaluated patient’s signs, symptoms, and laboratory data on the first visit to predict the severity of pulmonary involvement and their outcome regarding their initial findings. Methods All referred patients to the COVID-19 clinic of a tertiary referral university hospital were evaluated from April to August 2020. Four hundred seventy-eight COVID-19 patients with positive real-time reverse-transcriptase-polymerase chain reaction (RT-PCR) or highly suggestive symptoms with computed tomography (CT) imaging results with typical findings of COVID-19 were enrolled in the study. The clinical features, initial laboratory, CT findings, and short-term outcomes (ICU admission, mortality, length of hospitalization, and recovery time) were recorded. In addition, the severity of pulmonary involvement was assessed using a semi-quantitative scoring system (0–25). Results Among 478 participants in this study, 353 (73.6%) were admitted to the hospital, and 42 (8.7%) patients were admitted to the ICU. Myalgia (60.4%), fever (59.4%), and dyspnea (57.9%) were the most common symptoms of participants at the first visit. A review of chest CT scans showed that Ground Glass Opacity (GGO) (58.5%) and consolidation (20.7%) were the most patterns of lung lesions. Among initial clinical and laboratory findings, anosmia (P = 0.01), respiratory rate (RR) with a cut point of 25 (P = 0.001), C-reactive protein (CRP) with a cut point of 90 (P = 0.002), white Blood Cell (WBC) with a cut point of 10,000 (P = 0.009), and SpO2 with a cut point of 93 (P = 0.04) was associated with higher chest CT score. Lung involvement and consolidation lesions on chest CT scans were also associated with a more extended hospitalization and recovery period. Conclusions Initial assessment of COVID-19 patients, including symptoms, vital signs, and routine laboratory tests, can predict the severity of lung involvement and unfavorable outcomes.

Predictors for COVID-19 Complete Remission with HRCT Pattern Evolution: A Monocentric, Prospective Study

“…At the group level, lesion burden was consistently seen to be considerably greater in severe type patients than in common type patients when four evaluation techniques were used. It was established that both semiquantitative and quantitative approaches had great repeatability when evaluating inflammatory lesions and are capable of distinguishing between patients with the common type and those with the severe type [ 13 , 14 ]. The severity of the initial disease was associated with residual lung changes in 42% of discharged COVID-19 patients included in a mid-term follow-up study [ 15 ].…”

Evaluation of Biomarkers and Clinical Course in Patients Developing Neurologic Disorders due to COVID-19

“…In our study, as the lung CT score increased, the presence and the severity of the neurologic disorders increased. In the study of Yazdi et al [22], lung CT scores were The other limitation of this study is that neurological disorders were not handled and evaluated separately.…”

Lactate dehydrogenase and PaO2/FiO2 ratio at admission helps to predict CT score in patients with COVID-19: An observational study

“…In the literature, to our knowledge, few studies evaluated the clinical and laboratory parameters that can predict a worse CT score at admission [18] , [19] , [20] , [21] . The study by Francone et al, including 130 symptomatic COVID-19 patients showed that the Pan CT score was significantly correlated with C-reaction protein (CRP) (p < 0.0001) and D -dimer (p < 0.0001) levels [18] .…”

“…The study by Francone et al, including 130 symptomatic COVID-19 patients showed that the Pan CT score was significantly correlated with C-reaction protein (CRP) (p < 0.0001) and D -dimer (p < 0.0001) levels [18] . The paper by Yadzi et al [19] is the largest study, to our knowledge, including 478 participants, that evaluated the impact of different laboratory, clinical and demographic parameters to predict a CT score, with a score 0–25 based, similar to the Pan score. They found that anosmia, respiratory rate, CRP (with a cut-off of 90), WBC (with a cut-off of 10.000) and SpO2 (with a cut-off point of 93) was associated with a higher chest CT score.…”

“…The CT feature included ground glass opacity (GGO), consolidation, septal thickening and crazy paving [14] . The predictive power of the CT scan on the outcome was clear [15] , [16] , [17] , [18] , [19] , [20] , [21] . However, to our knowledge, few studies have been carried out on the identification of biochemical factors that predict a worse CT score at admission for COVID-19 [18] , [19] , [20] , [21] .…”