Asemptomatik ve semptomatik COVID-19 vakalarının BT görüntülerinin incelenmesi

Year 2021, Volume: 8 Issue: 1, 49 - 53, 01.03.2021

Muhammed Emin Demirkol , Musa Kaya , Mehmet Balcı

Abstract

Amaç: Klinik bulgu vermeyen COVID-19 vakalarının semptomatik vakalara kıyasla radyolojik görüntüleme bulgularının özelliklerini ortaya koymaktır.
Yöntem: 01.06.2020-30.06.2020 tarihleri arasında Bolu İzzet Baysal EAH ve İzzet Baysal DH de COVID-19 tanısı almış 209 hasta dosyası incelenmiştir.. Mann Whitney U testi, Kruskal Wallis testi ve Ki-Kare testlerinden yararlanılmıştır. Etki büyüklüğü cohen d ile incelenmiş ve p<0.05 istatistiksel olarak anlamlı kabul edilmiştir.
Bulgular: Semptom varlığı cinsiyete göre istatistiksel olarak anlamlı olmayıp 51 yaş ve üzeri olan hastalarda daha fazla semptom ile karşılaşılmaktadır. Semptom gelişen hastaların D DİMER, LDH ve CRP laboratuvar değerleri anlamlı olarak daha yüksek olup yine bu grubun %57.3’ünde D-DİMER, %75’inde CRP ve % 78.2’sinde LDH parametreleri referans değerinden yüksek çıkmıştır. Beklendiği üzere semptom varlığı ve COVID 19 ile uyumlu BT bulgusu varlığı istatistiksel olarak anlamlıdır ancak semptom göstermeyen hastalarda da %72.9’luk yüksek bir oranla COVID 19 ile uyumlu BT bulgusu tespit edilmiştir.
Tartışma ve Sonuç: COVID-19 vakalarının erken tespiti ve sonrasında izole edilerek tedavi uygulanması için semptomatik vakaların yanı sıra asemptomatik vakaların da tespit edilmesi hastalığın yayılımının kontrol altına alınmasında büyük önem taşır. Bu nedenle sağlık kuruluşlarına COVID-19 olası tanısıyla başvuran hastalar için ayırıcı tanı koyma noktasında RT-PCR test sonuçları kesinleşene kadar anında okunabilme özelliği ile BT, hızlı ve değerli bir araç olarak öne çıkmaktadır.

Keywords

COVID-19, Bilgisayarlı Tomografi (BT), Asemptomatik

Supporting Institution

YOK

Project Number

YOK

Thanks

desteklerinden dolayı Neslihan KAYA'ya teşekkür ederiz.

Review of CT images of asymptomatic and symptomatic COVID-19 cases

Abstract

Objective: To reveal the characteristics of radiological imaging findings of COVID-19 cases without clinical signs compared to symptomatic cases.
Method: The files of 209 patients diagnosed with COVID-19 in Bolu İzzet Baysal TRH and İzzet Baysal PH between 01.06.2020-30.06.2020 were examined. Mann Whitney U test, Kruskal Wallis test and Chi-square tests were used. The effect size was examined with cohen d and p <0.05 was considered statistically significant.
Results: The presence of symptoms is not statistically significant according to gender, and more symptoms are encountered in patients aged 51 and over. D DIMER, LDH and CRP laboratory values of the patients who developing symptoms were significantly higher. Again, the parameters of D-DIMER in 57.3%, CRP in 75% and LDH in 78.2% of this group were higher than the reference value. As expected, the presence of symptoms and the presence of CT findings consistent with COVID 19 are statistically significant. However, CT findings compatible with COVID 19 were detected with a high rate of 72.9% in patients without symptoms.
Discussion: For early detection and treatment of COVID-19 cases, detection of symptomatic cases as well as asymptomatic cases is of great importance in controlling the spread of the disease. For this reason; CT stands out as a fast and valuable tool with its ability to be read instantly until the RT-PCR test results are finalized at the point of making differential diagnosis for patients admitted to healthcare institutions with a possible diagnosis of COVID-19.

Keywords

COVID-19, Computed Tomography (CT), Asymptomatic

Project Number

YOK

References

• Zhu, N., Zhang, D., Wang, W., Li, X., Yang, B., Song, J., ... & Niu, P. (2020). A novel coronavirus from patients with pneumonia in China, 2019. New England Journal of Medicine, 382(8), 727-733.
• Yang L, Tian D, Liu W. Sheng Wu Gong Cheng Xue Bao. 2020; 36(4):593-604.
• Wang, D., Hu, B., Hu, C., Zhu, F., Liu, X., Zhang, J., ... & Zhao, Y. (2020). Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. Jama, 323(11), 1061-1069.
• Nishiura, H., Kobayashi, T., Miyama, T., Suzuki, A., Jung, S. M., Hayashi, K., ... & Linton, N. M. (2020). Estimation of the asymptomatic ratio of novel coronavirus infections (COVID-19). International journal of infectious diseases, 94, 154.
• Mizumoto, K., Kagaya, K., Zarebski, A., & Chowell, G. (2020). Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020. Eurosurveillance, 25(10), 2000180.
• Huff, H. V., & Singh, A. (2020). Asymptomatic transmission during the COVID-19 pandemic and implications for public health strategies. [published online ahead of print, 2020 May 28]. Clinical Infectious Diseases. ciaa654.
• Hayran Murat ve Hayran, Mutlu (2018). Sağlık Araştırmaları İçin Temel İstatistik. 2.Baskı. Omega Araştırma.
• Cohen, Jacob (1988). Statistical Power Analysis for the Behavioral Sciences: 2 Ed. Hillsdale. NJ: Erlbaum.
• Yu, X., & Yang, R. (2020). COVID‐19 transmission through asymptomatic carriers is a challenge to containment. Influenza and Other Respiratory Viruses. 14(4), 474-475.
• Zhou, R., Li, F., Chen, F., Liu, H., Zheng, J., Lei, C., & Wu, X. (2020). Viral dynamics in asymptomatic patients with COVID-19. International Journal of Infectious Diseases. 96: 288-290.
• Zou, L., Ruan, F., Huang, M., Liang, L., Huang, H., Hong, Z., ... & Guo, Q. (2020). SARS-CoV-2 viral load in upper respiratory specimens of infected patients. New England Journal of Medicine, 382(12), 1177-1179.
• Tian, S., Hu, N., Lou, J., Chen, K., Kang, X., Xiang, Z., ... & Chen, G. (2020). Characteristics of COVID-19 infection in Beijing. Journal of Infection, 80(4), 401-406
• Kim, G. U., Kim, M. J., Ra, S. H., Lee, J., Bae, S., Jung, J., & Kim, S. H. (2020). Clinical characteristics of asymptomatic and symptomatic patients with mild COVID-19. Clinical Microbiology and Infection, 26(7), 948.e1-948.e3
• Amgalan, A., & Othman, M. (2020). Hemostatic laboratory derangements in COVID-19 with a focus on platelet count. Platelets, 31(6), 740-745.
• Meng, H., Xiong, R., He, R., Lin, W., Hao, B., Zhang, L., ... & Yang, W. (2020). CT imaging and clinical course of asymptomatic cases with COVID-19 pneumonia at admission in Wuhan, China. Journal of Infection. 81(1), e33-e39
• Hu, Z., Song, C., Xu, C., Jin, G., Chen, Y., Xu, X., ... & Wang, J. (2020). Clinical characteristics of 24 asymptomatic infections with COVID-19 screened among close contacts in Nanjing, China. Science China Life Sciences, 63(5), 706-711.