Correlations of renal parenchymal attenuations and CT severity scores on three consecutive CTs in COVID-19 patients

Yıl 2023, , 487 - 493, 27.03.2023

Ahmet Turan Kaya , Burcu Akman

https://doi.org/10.32322/jhsm.1227526

Öz

Aim: We aimed to investigate the correlation between the temporal changes of computed tomography severity score (CT-SS) ​​and mean renal parenchymal attenuation (MRPA) values in consecutive chest computed topographies (CT).
Material and Method: This retrospective, single-center study included 65 (≥18 years) COVID-19 patients with positive RT-PCR tests. A radiologist calculated three consecutive chest CT-SSs and measured the MPRAs on CTs from the upper half of each kidney included in the cross-section. Paired samples test and Wilcoxon signed-rank test were used to evaluate the temporal changes of mean renal parenchymal attenuation (RPA) and median CT-SS values, in three consecutive CTs. Spearman's test was used to evaluate the correlation of each RPA and CT-SS value on three consecutive CTs.
Results: The study population included 65 patients with a mean age of 61.49±13.91 years. A total of 36/65 (55.4%) were male. We found a significant increase between the first and second CT-SS (p<0.001) values, and a significant decrease between the first and second RPA (p<0.001) values. There were statistically significant moderate negative linear correlations between MRPA values and consecutive CT-SSs in COVID-19 patients (correlation coefficient [r]1=-0.320, p=0.009; r2=-0.381, p=0.002; r3=-0.393, p=0.001).
Conclusion: The decrease in renal parenchymal attenuation in non-enhanced computed tomography is related to the severity of pneumonia in COVID-19 patients and may be an attention factor for acute kidney injury.

Anahtar Kelimeler

COVID-19, Coronavirus, CT severity score, renal parenchymal attenuation

Kaynakça

• Behzad S, Aghaghazvini L, Radmard AR, Gholamrezanezhad A. Extrapulmonary manifestations of COVID-19: radiologic and clinical overview. Clin Imag 2020; 66: 35–41.
• Vishwajeet V, Krishna H, Ghatak S, Elhence PA, Ambwani S, Varthya SB. Renal histopathological changes in coronavirus disease 2019 patients: a systematic review and meta-analysis of individual patient data. Saudi J Kidney Dis Transplant 2021; 32: 1523–42.
• Gheblawi M, Wang K, Viveiros A, et al. Angiotensin-converting enzyme 2: SARS-CoV-2 receptor and regulator of the renin-angiotensin system: celebrating the 20th anniversary of the discovery of ACE2. Circ Res 2020; 126: 1456–74.
• Hamming I, Timens W, Bulthuis MLC, Lely AT, Navis GJ van, van Goor H. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol A J Pathol Soc Gt Britain Irel 2004; 203: 631–7.
• Eckerle I, Müller MA, Kallies S, Gotthardt DN, Drosten C. In-vitro renal epithelial cell infection reveals a viral kidney tropism as a potential mechanism for acute renal failure during Middle East Respiratory Syndrome (MERS) Coronavirus infection. Virol J 2013; 10: 1–5.
• Kunutsor SK, Laukkanen JA. Renal complications in COVID-19: a systematic review and meta-analysis. Ann Med 2020; 52: 345–53.
• Martinez-Rojas MA, Vega-Vega O, Bobadilla NA. Is the kidney a target of SARS-CoV-2? Am J Physiol Physiol 2020; 318: 1454–62.
• Cheng Y, Luo R, Wang K, et al. Kidney disease is associated with in-hospital death of patients with COVID-19. Kidney Int 2020; 97: 829–38.
• Ronco C, Reis T. Kidney involvement in COVID-19 and rationale for extracorporeal therapies. Nat Rev Nephrol 2020; 16: 308–10.
• Su H, Yang M, Wan C, et al. Renal histopathological analysis of 26 postmortem findings of patients with COVID-19 in China. Kidney Int 2020; 98: 219–27.
• Pan X, Xu D, Zhang H, Zhou W, Wang L, Cui X. Identification of a potential mechanism of acute kidney injury during the COVID-19 outbreak: a study based on single-cell transcriptome analysis. Intensive Care Med 2020; 46: 1114–6.
• Hirsch JS, Ng JH, Ross DW,et al. Acute kidney injury in patients hospitalized with COVID-19. Kidney Int 2020; 9: 209–18.
• Huang Q, Li J, Lyu S, et al. COVID-19 associated kidney impairment in adult: Qualitative and quantitative analyses with non-enhanced CT on admission. Eur J Radiol 2020; 131: 109240.
• Goldman SM, Faintuch S, Ajzen SA, et al. Diagnostic Value of Attenuation Measurements of the Kidney on Unenhanced Helical CT of Obstructive Ureterolithiasis. Am J Roentgenol 2004; 182: 1251–4.
• Pan F, Ye T, Sun P, Gui S, Liang B, Li L. Time course of lung changes at chest CT during Recovery. Radiology 2020; 295: 715–21.
• Zhou S, Chen C, Hu Y, Lv W, Ai T, Xia L. Chest CT imaging features and severity scores as biomarkers for prognostic prediction in patients with COVID-19. Ann Transl Med 2020: 8: 1449.
• Francone M, Iafrate F, Masci GM, et al. Chest CT score in COVID-19 patients: correlation with disease severity and short-term prognosis. Eur Radiol 2020; 30: 6808–17.
• Li Z, Wu M, Yao J, et al. Caution on kidney dysfunctions of COVID-19 patients. SSRN Electron J 2020; 1–25.
• Martinez-Rojas MA, Vega-Vega O, Bobadilla XNA. Is the kidney a target of SARS-CoV-2? Am J Physiol - Ren Physiol 2020; 318: 1454–62.
• Zou X, Chen K, Zou J, Han P, Hao J, Han Z. Single-cell RNA-seq data analysis on the receptor ACE2 expression reveals the potential risk of different human organs vulnerable to 2019-nCoV infection. Front Med 2020; 14: 185–92.
• Hamming I, Timens W, Bulthuis M, Lely AT, Navis GJ, Van Goor H. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. Wiley Online Libr 2004; 203: 631–7.
• Diao B, Wang C, Wang R, et al. Human kidney is a target for novel severe acute respiratory syndrome coronavirus 2 infection. Nat Commun 2021; 12: 2506.
• Papadimitriou JC, Drachenberg CB, Kleiner D, Choudhri N, Haririan A, Cebotaru V. Tubular Epithelial and Peritubular Capillary Endothelial Injury in COVID-19 AKI. Kidney Int Rep. 2021; 6: 518-25.
• Adamczak M, Surma S, Wiecek A. Acute kidney injury in patients with COVID-19: Epidemiology, pathogenesis and treatment. Adv Clin Exp Med 2022; 31: 317–26.
• Weiss P, Murdoch DR. Clinical course and mortality risk of severe COVID-19. Lancet 2020; 395: 1014-5.
• Chawla LS, Eggers PW, Star RA, Kimmel PL. Acute kidney injury and chronic kidney disease as interconnected syndromes. N Engl J Med 2014; 371: 58–66.
• Stunell H, Buckley O, Feeney J, Geoghegan T, Browne RFJ, Torreggiani WC. Imaging of acute pyelonephritis in the adult. Eur Radiol 2007; 17: 1820–8.