Correlation of Patient Features of Covid-19, Laboratory Tests and Computed Tomography Findings: Single-Center Retrospective Study

Abstract

Aim: Computed Tomography (CT) findings, clinical and laboratory data are very important in the diagnosis and treatment process of Coronavirus Disease 2019 (COVID-19). In this study, the relationship between these findings was investigated. Material and method: 93 patients with positive Reverse-Transcriptase Polymerase Chain Reaction (RT-PCR) test for SARS-CoV-2 were included in the study. CT findings, laboratory tests, and the World Health Organization Clinical Progress Scale (WHO-CPS) were evaluated. Results: Of the patients, 52 were male and 41 were female. The mean age was 46. The most common laboratory finding is high CRP levels (67.74%). GGO, consolidation, halo sign and air bronchogram were most frequent CT findings. The mean of CT score was 4.91. A statistically significant positive correlation was found between CT score and age, D-dimer, CRP, ferritin and fibrinogen. There was a significant negative correlation between CT score, lymphocyte count and oxygen saturation. There was no correlation between CT score and procalcitonin, gender and presence of comorbid disease. There was a moderate negative correlation between CT score and IL-6 blocker use and corticosteroid therapy, and a mild negative correlation between CT score and favipravir use. The correlation between CT score and immunosuppressant use was not significant. We also found a moderate positive correlation between WHO-CPS and CT scores. Conclusion: The CT score is correlated with some laboratory and clinical markers, and we think that these findings indicate that CT is a very useful test in the diagnosis as well as in the follow-up.

Keywords

• COVID-19
• CT
• laboratory findings

COVID-19'UN HASTA ÖZELLİKLERİ, LABORATUVAR TESTLERİ VE BİLGİSAYARLI TOMOGRAFİ BULGULARININ KORELASYONU: TEK MERKEZLİ RETROSPEKTİF ÇALIŞMA

Öz

Amaç: Koronavirüs Hastalığı 2019 (COVID-19) tanı ve tedavi sürecinde Bilgisayarlı Tomografi (BT) bulguları, klinik ve laboratuvar verileri çok önemlidir. Bu çalışmada, bu bulgular arasındaki ilişki araştırılmıştır. Materyal ve metod: SARS-CoV-2 için Revers-Transkriptaz Polimeraz Zincir Reaksiyonu (RT-PCR) testi pozitif çıkan 93 hasta çalışmaya dahil edildi. BT bulguları, laboratuvar testleri ve Dünya Sağlık Örgütü Klinik İlerleme Ölçeği (DSÖ-KİÖ)değerlendirildi. Bulgular: Hastaların 52’si erkek, 41’I kadındı. Ortalama yaş 46 idi. En sık görülen laboratuvar bulgusu yüksek CRP düzeyleridir (%67,74). Buzlu cam, konsolidasyon, halo işareti ve hava bronkogramı en sık BT bulgularıydı. BT skorunun ortalaması 4.91 idi. BT skoru ile yaş, D-dimer, CRP, ferritin ve fibrinojen arasında istatistiksel olarak anlamlı pozitif korelasyon bulundu. BT skoru ile lenfosit sayısı ve oksijen satürasyonu arasında anlamlı negatif korelasyon mevcuttu. BT skoru ile prokalsitonin, cinsiyet ve komorbid hastalık varlığı arasında korelasyon yoktu. BT skoru ile IL-6 bloker kullanımı ve kortikosteroid tedavisi arasında orta derecede negatif korelasyon, BT skoru ile favipravir kullanımı arasında hafif negatif korelasyon vardı. BT skoru ile immünosupresan kullanımı arasındaki korelasyon anlamlı değildi. Ayrıca DSÖ-KİÖ ve BT skorları arasında orta düzeyde pozitif korelasyon bulduk. Sonuç: BT skoru bazı laboratuvar ve klinik belirteçlerle korelasyon göstermekte olup bu bulguların BT’nin tanıda olduğu kadar takipte de oldukça yararlı bir tetkik olduğuna işaret ettiğini düşünmekteyiz.

Anahtar Kelimeler

• COVID-19
• BT
• laboratuvar bulguları

Kaynakça

1. 1. Pan F, Ye T, Sun P, et al. Time course of lung changes at chest CT during recovery from coronavirus disease 2019 (COVID-19). Radiology. 2020;295:715-21. doi: 10.1148/radiol.2020200370.
2. 2. Dilek O, Kaya O, Akkaya H, et al. Diagnostic performance and interobserver agreement of CO-RADS: evaluation of classification in radiology practice. Diagn Interv Radiol. 2021;27: 615-20. doi: 10.5152/dir.2021.201032
3. 3. Ufuk F, Savas R. Chest CT features of the novel coronavirus disease (COVID-19). Turk J Med Sci. 2020;50:664-78. doi: 10.3906/sag-2004-331.
4. 4. Ai T, Yang Z, Hou H, et al. Correlation of Chest CT and RT-PCR Testing for Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases. Radiology. 2020;296:32-40. doi: 10.1148/radiol.2020200642
5. 5. Salehi S, Abedi A, Balakrishnan S, Gholamrezanezhad A. Coronavirus disease 2019 (COVID-19): a systematic review of imaging findings in 919 Patients. AJR. 2020;14:1-7. doi: 10.2214/AJR.20.23034.
6. 6. Dilek O, Demirel E, Akkaya H, Belibagli MC, Soker G, Gulek B. Different chest CT scoring systems in patients with COVID-19: could baseline CT be a helpful tool in predicting survival in patients with matched ages and co-morbid conditions?. Acta Radiol. 2021;63:615-22. doi: 10.1177/02841851211006316.
7. 7. Zhang X, Zheng J, Qian E, Xue L, Liu X. The association of clinical features and laboratory findings of COVID-19 infection with computed pneumonia volume. Medicine. 2022;101:(7)e28856. doi: 10.1097/MD.0000000000028856
8. 8. Hansell DM, Bankier AA, MacMahon H, et al. Fleischner Society: glossary of terms for thoracic imaging. Radiology. 2008;246:697-722. doi: 10.1148/radiol.2462070712.

9. 9. WHO Working Group on the Clinical Characterisation and Management of COVID-19 infection. A minimal common outcome measure set for COVID-19 clinical research. Lancet Infect Dis. 2020;20:192-7. doi: 10.1016/S1473-3099(20)30483-7.
10. 10. Zhang ZL, Hou YL, Li DT, Li FZ. Laboratory findings of COVID-19: a systematic review and meta-analysis. Scand J Clin Lab Invest. 2020;80:441-7.
11. 11. Gündüz Y, Karabay O, Erdem AF, Arik E, Öztürk MH. Evaluation of initial chest computed tomography (CT) findings of COVID-19pneumonia in 117 deceased patients: a retrospective study. Turk J Med Sci. 2021;51:929-38. doi: 10.1080/00365513.2020.1768587.
12. 12. Mahat RK, Panda S, Rathore V, et al. The dynamics of inflammatory markers in coronavirus disease-2019 (COVID-19) patients: a systematic review and meta-analysis. Clin epidemiol glob health. 2021;11:100727. doi: 10.1016/j.cegh.2021.100727. 13. Ali A, Noman M, Guo Y, et al. Myoglobin and C-reactive protein are efficient and reliable early predictors of COVID-19 associated mortality. Sci Rep. 2021;16;11:5975. doi: 10.1038/s41598-021-85426-9.
13. 14. Kazemi E, Soldoozi, Nejat R, Ashkan F, Sheibani H. The laboratory findings and different COVID-19 severities: a systematic review and meta-analysis. Ann Clin Microbiol Antimicrob. 2021;20:17. doi: 10.1186/s12941-021-00420-3.
14. 15. Joshi S, Parkar J, Ansari A, et al. Role of favipiravir in the treatment of COVID-19. Int J Infect Dis. 2021;102:501-8. doi: 10.1016/j.ijid.2020.10.069
15. 16. Bosaeed M, Alharbi A, Mahmoud E, et al. Efficacy of favipiravir in adults with mild COVID-19: a randomized, double-blind, multicentre, placebo-controlled clinical trial. Clin Microbiol Infect. 2022;28:602-8. doi: 10.1016/j.cmi.2021.12.026.
16. 17. Zhu J, Chen C, Shi R, Li B. Correlations of CT scan with high-sensitivity C-reactive protein and D-dimer in patients with coronavirus disease 2019. Pak J Med Sci. 2020;36:1397. doi: 10.12669/pjms.36.6.2961
17. 18. Saeed GA, Gaba W, Shah A, et al. Correlation between chest CT severity scores and the clinical parameters of adult patients with COVID-19 pneumonia. Radiol Res Pract. 2021:6697677. doi: 10.1155/2021/6697677.
18. 19. Dogan HO, Bolat S, Buyuktuna SA, et al D. The use of laboratory parameters and computed tomography score to determine intensive care unit requirement in COVID-19: Turk J Biochem. 2021;46:157-66. doi: 10.1515/tjb-2020-0359.