Olası ve kesin COVID-19 vakalarının sosyodemografik, klinik, radyolojik ve laboratuvar bulgularının retrospektif olarak karşılaştırılması

Öz

Amaç: Kliniğimizde takip edilen kesin COVID-19 vakalar ile olası COVID-19 vakalar arasındaki sosyodemografik, klinik, BT ve laboratuvar bulgularının farklarını incelemeyi amaçladık. Gereç ve yöntem: İlk vaka tarihi olan 13 Mart 2020 ile 5 Mayıs 2020 arasında, olası ve kesin COVID-19 tanısıyla Göğüs Hastalıkları servisinde yatan tüm hastaların verileri retrospektif olarak incelendi. Hastaların toraks BT bulguları, hastaların klinik ve PCR test sonuçlarına körleştirilen iki farklı radyolog tarafından CO-RADS sınıflamasına göre ayrı ayrı yorumlandı ve daha sonra ortak değerlendirme ile konsensüs sağlandı. Klinik, laboratuvar ve görüntüleme bulguları ile çoklu regresyon modellemesi yapıldı. Bulgular: Çalışmaya 38 RT-PCR pozitif, 62 RT-PCR negatif olmak üzere toplam 99 hasta dahil edildi. Nötrofil/lenfosit oranı (NLR) ve lenfosit sayısı, RT-PCR pozitif hastalarda istatistiksel olarak anlamlı düzeyde daha düşüktü (sırasıyla p = 0.038, p = 0.041). Benzer şekilde, pozitif hastalarda CRP değerlerinin istatistiksel olarak anlamlı düzeyde düşük olduğu gözlendi (p = 0.029). RT-PCR (+) ile RT-PCR (-) ancak toraks BT ‘si CO-RADS evrelemesine göre pozitif olan hastaların karşılaştırmalarında, RT-PCR (-) ancak toraks BT pozitif olan grupta anlamlı şekilde WBC, LDH ve CRP değerlerinin daha yüksek olduğu görüldü (sırasıyla p=0.001, p=0.033, p=0.004). Öksürük, WBC, LDH, CRP değerleri ve toraks BT skoru kullanılarak geliştirilen modelde en yüksek AUC değeri elde edilmiş, RT-PCR pozitifliğini ayırt etmede başarılı olabileceği görüldü (AUC=0.725, 95% CI: 0.619-0.830) Sonuç: Klinik bulgular varlığında RT-PCR pozitifliğini beklemeden COVID-19 uyumlu BT bulguları (CO-RADS'ye göre evre 4-5) ile yüksek WBC, CRP VE LDH varsa COVID-19 olasılığı artacaktır.

Anahtar Kelimeler

• CO-RADS
• Olası COVID-19
• RT-PCR
• SARS-CoV-2

Retrospective comparison of the sociodemographic, clinical, radiological and laboratory findings of probable and definitive COVID-19 cases

Öz

Purpose: We aimed to determine the number of possible and precise cases among the patients hospitalized in our clinic and to examine the differences between the sociodemographic, clinical, chest CT and laboratory findings of these two groups. Materials and methods: The data of all patients hospitalized at the department of pulmonology service between March 13 as the date of the first case and May 5 with probable and definitive COVID-19 were evaluated retrospectively. Patient ward files and hospital data management system were examined. Chest CT findings of the patients were interpreted by two radiologists separately according to the CO-RADS classification blinded to clinical and PCR test results of the patients and then consensus was achieved with joint evaluation. Results: A total of 99 patients, 38 RT-PCR positive, 61 RT-PCR negative, were included in the study. Neutrophil-to-lymphocyte ratio(NLR) values and lymphocyte count were lower at a statistically significant level in positive patients(respectively p=0.038, p=0.041). Similarly, CRP values were observed to be lower at a statistically significant level in positive patients(p=0.029). When the patients with RT-PCR(+) and RT-PCR(-) but with positive chest CT findings according to CO-RADS staging were compared, the values of WBC, LDH and CRP level was observed to be high were statistically significant in the group with RT-PCR(-) but positive chest CT findings. Conclusion: In the presence of clinical findings, without waiting for RT-PCR positivity, the probability of COVID-19 disease will increase if there are elevated WBC, CRP and LDH findings with CT findings(stage 4-5 according to CO-RADS).

Anahtar Kelimeler

• CO-RADS
• Probable COVID-19
• RT-PCR
• SARS-CoV-2

Kaynakça

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