Correlating CT severity score and laboratory parameters in COVID-19 patients: the Indian experience (original) (raw)
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Egyptian Journal of Radiology and Nuclear Medicine, 2022
Background: Since November 2019, the rapid outbreak of coronavirus disease 2019 (COVID-19) has become a public health emergency of international concern. COVID-19 disease is caused by a new variant of coronavirus, named as 'severe acute respiratory syndrome coronavirus 2. ' Chest CT has a potential role in the diagnosis, detection of complications and in predicting clinical recovery of patients or progression of coronavirus disease 2019. Degree and severity of lung involvement can be assessed by 25 point CT severity score. This quantification plays an important role to modify the treatment plan at times in critically ill patient of COVID-19. Hence, the purpose of present study was to describe and quantify the severity of COVID-19 infection on chest computed tomography (CT) by 25-point CT severity score and to determine the relationship of CT severity score with clinical and laboratory parameters. Results: A total of 150 patients with COVID-19 disease were assessed. Mean age of the study group was 54.46 years (62.7% males and 37.3% females). The most common comorbidity present in the study group was diabetes mellitus, which was present in 17.3% cases. Severity of disease was significantly associated with age of the patient. CT severity score was positively correlated with lymphopenia and raised CRP, D-dimer and serum ferritin levels. A significant statistical correlation was found between CT severity grade and patient survival. Conclusions: This is a large comprehensive study, collecting data from 150 cases of COVID-19 pneumonia patients, in a tertiary care hospital in India to describe the correlation of CT severity score with clinical land laboratory parameters. Chest CT severity score correlates well with laboratory parameters and can aid in predicting COVID-19 disease outcome.
Journal of Chittagong Medical College Teachers' Association
Background: Studies elsewhere in the world observed that, chest Computed Tomography (CT) scoring could help to stratify patient’s risk and predict short-term outcome of patients with COVID-19 pneumonia. But report from Bangladesh in this regard is in short supply. This study was aimed to investigate the relationship between the percentage of lung involvement as defined by CT scan score and outcome of COVID-19 patients admitted in a COVID dedicated hospital of Bangladesh. Materials and methods: This prospective observational study included 103 RTPCR confirmed COVID19 patients admitted in Chittagong Medical College Hospital (CMCH). All patients had a non-contrast HRCT scan done at presentation. Severity of CT score was categorized as Mild: score 7 or less, Moderate: score 8–17 and severe: score 18 or more. Outcome data in terms of oxygen requirement, length of hospital stay and in-hospital mortality were collected. Results: The mean age was 53.12 ± 12.69 years (58.3% males, 41.7% fema...
Purpose: The CT Severity Score has great significance in assessing the extent of pneumonia involvement with differentiation of mild, critical and severe types and helps clinicians achieve early diagnosis and accurate treatment. Material and methods: 100 COVID-19 positive patients were analyzed for CT-SS and its correlation with clinical severity, laboratory markers and duration of hospital stay. The ROC curve was analyzed to obtain the optimum CT-SS threshold to discriminate patients in the common group from the patients of severe & critical groups and discriminate patients in the critical group from the patients of severe & common groups. Results: The study comprised 57 common category, 23 severe category and 20 critical category patients. The mean chest CT-SS score was highest in critical patients (35.95), higher in severe patients (25.52) than common patients (12.18) with mean duration of admission was 13.35, 12 and 7.65 days respectively (p-value of 0.000). The optimum CT-SS threshold for discriminating patients in the common group from the patients of severe & critical groups was 21.5 with sensitivity of 93%, specificity of 86%. The optimum CT-SS threshold for discriminating patients in the critical group from the patients of severe & common groups was 28.5 with a sensitivity & specificity of 90%. Conclusion: Initial Chest CT-SS showed significant association with duration of hospital stay and short-term prognosis of patients. Chest CT Severity Score can be used to evaluate the clinical severity of the patients on initial scans, to differentiate common, severe and critical patients and decide their management.
Haseki Tıp Bülteni, 2023
It has been reported that the increased neutrophil/lymphocyte ratio (NLR) is associated with a poor prognosis in Coronavirus disease-2019 (COVID-19) patients. We aimed to correlate three consecutive computed tomography severity score (CT-SS) values with simultaneous NLR and other laboratory parameters and investigate their temporal changes effects on the prognosis of COVID-19 patients. Methods: This single-center cross-sectional study included 99 (aged ≥18 years) COVID-19 patients hospitalized between March 1, 2021, and June 30, 2021. Demographic data, laboratory findings, and intensive care unit (ICU) admissions were obtained from electronic medical records. We divided patients into two groups: ICU and non-ICU patients A radiologist calculated three consecutive chest CT-SSs using a 25-point visually semiquantitative system. Spearman's rho correlation was used to evaluate correlations between CT-SSs and laboratory parameters in ICU and non-ICU patients. Results: The study population included 99 patients with a mean age of 61.17±14.36 years. Significant associations were found between the third-highest values of CRP (p=0.005), D-dimer (p=0.007), lactate dehydrogenase (p=0.027), and ICU admission. While there was no statistical significance between the first and second CT-SS and ICU admissions, there was a significant relationship between the third CT-SS and ICU admissions (p=0.013). Moderate positive correlations between the first NLR and CT-SS (p=0.025, r=0.488) and the second NLR and CT-SS (p=0.001, r=0.650) were found in ICU patients. Conclusion: Our results demonstrate the importance of late follow-up chest CT and laboratory parameters for the prognosis and ICU admissions of COVID-19 patients.
An Association between CT Score and the Severity of COVID-19
Journal of Pharmaceutical Research International
Introduction: COVID-19 has changed the world fabric. While many still haven’t recovered from the grief of losing their loved ones; the virus continues to mutate leaving the world to deal with a social and economic pandemic. In this study we aim at determining an association between CT SCORE and the severity of COVID-19 thereby understanding the prognosis/severity of disease in patients. Method: A prevalidated google questionnaire was used to obtain data. The study population consisted of people who tested real time RT-PCR COVID-19 positive. Results: A statistically significant correlation was seen between CT score and outcome of disease. Conclusion: Routine CT scan of suspected COVID-19 cases gives early diagnosis; it could also guide in hastening the treatment received by the patient and improve overall prognosis be used as a guide for the management of the patients and hence improve overall prognosis.
Chest CT score in COVID-19 patients: correlation with disease severity and short-term prognosis
European Radiology, 2020
Objectives To correlate a CT-based semi-quantitative score of pulmonary involvement in COVID-19 pneumonia with clinical staging of disease and laboratory findings. We also aimed to investigate whether CT findings may be predictive of patients' outcome. Methods From March 6 to March 22, 2020, 130 symptomatic SARS-CoV-2 patients were enrolled for this single-center analysis and chest CT examinations were retrospectively evaluated. A semi-quantitative CT score was calculated based on the extent of lobar involvement (0:0%; 1, < 5%; 2:5-25%; 3:26-50%; 4:51-75%; 5, > 75%; range 0-5; global score 0-25). Data were matched with clinical stages and laboratory findings. Survival curves and univariate and multivariate analyses were performed to evaluate the role of CT score as a predictor of patients' outcome. Results Ground glass opacities were predominant in early-phase (≤ 7 days since symptoms' onset), while crazy-paving pattern, consolidation, and fibrosis characterized late-phase disease (> 7 days). CT score was significantly higher in critical and severe than in mild stage (p < 0.0001), and among late-phase than early-phase patients (p < 0.0001). CT score was significantly correlated with CRP (p < 0.0001, r = 0.6204) and D-dimer (p < 0.0001, r = 0.6625) levels. A CT score of ≥ 18 was associated with an increased mortality risk and was found to be predictive of death both in univariate (HR, 8.33; 95% CI, 3.19-21.73; p < 0.0001) and multivariate analysis (HR, 3.74; 95% CI, 1.10-12.77; p = 0.0348). Conclusions Our preliminary data suggest the potential role of CT score for predicting the outcome of SARS-CoV-2 patients. CT score is highly correlated with laboratory findings and disease severity and might be beneficial to speed-up diagnostic workflow in symptomatic cases. Key Points • CT score is positively correlated with age, inflammatory biomarkers, severity of clinical categories, and disease phases. • A CT score ≥ 18 has shown to be highly predictive of patient's mortality in short-term follow-up. • Our multivariate analysis demonstrated that CT parenchymal assessment may more accurately reflect short-term outcome, providing a direct visualization of anatomic injury compared with non-specific inflammatory biomarkers. Keywords Severe acute respiratory syndrome coronavirus 2. COVID-19. Pneumonia. Tomography, X-ray computed Marco Francone and Franco Iafrate contributed equally to this work.
https://www.ijrrjournal.com/IJRR\_Vol.9\_Issue.7\_July2022/IJRR-Abstract15.html, 2022
Coronavirus Disease 2019 (COVID-19) has been a pandemic for two years after the World Health Organization (WHO) initially announced it on March 11, 2020. The conventional diagnosis of COVID-19 is often made using a reverse transcription polymerase chain reaction (RT-PCR) and supported by radiographic examinations such as chest CT-SCAN which is regarded to be an additional modality to help quantify the severity of COVID-19 disease. This study's objective is to examine the link between the severity of cases and the chest CT-SCAN pictures observed in COVID-19 patients. The study was conducted at the Wahidin Sudirohusodo Hospital in Makassar. To determine the association between the severity of COVID-19 and the CT-SCAN image of the thorax, a cross-sectional study was conducted and statistical analysis was performed using the chi-square test. A study of 382 samples revealed that the majority of COVID-19 case subjects with a significant relationship to the severity of severe cases were male, older than 50 years, smokers, with comorbid diabetes mellitus, hypertension, kidney failure, heart disease, and evaluation of typical chest CT-SCAN images. Tests of statistical significance revealed a correlation between extreme clinical severity and severe CT-SCAN pictures of the thorax. The thoracic CT-SCAN can modalities shown has a benefit to be utilized as a diagnostic and evaluating tool of the patients.
Pakistan Journal of Medical and Health Sciences, 2021
Background: High-resolution computed tomography (HRCT) chest has a key role in diagnosis COVID-19, as it provides specific imaging features, i.e., bilateral, peripheral and sub-pleural, ground-glass opacity (GGO), consolidation and many associated findings. Aim: To provide the detailed chest HRCT findings along with clinical information in patients with COVID-19. Methods: A cross-sectional study was conducted in the Department of Radiology SZPGMI, Lahore. Information on clinical data, chest radiography appearance and comorbidities were recorded ona designed proforma. HRCT chest findings were recorded in terms of pattern, distribution, laterality, and other findings. HRCT chest severity was calculated using a 25 point CT severity score. Kendall’s Tau test applied to investigate the correlation between the severity of HRCT chest with clinical severity levels of COVID-19. Results: Fever (74%) was the most reported presenting symptom, followed by dry cough (70%). The majority of patient...
Predictors of The Chest CT Score in COVID-19 Patients: A Cross-Sectional Study
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 CODID-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 s...
Pakistan Armed Forces Medical Journal
Objective: To associate CT severity score with inflammatory markers and to determine outcomes of COVID-19 patients admitted to CMH Lahore. Study Design: Comparative cross-sectional study. Place and Duration of Study: Combined Military Hospital, Lahore Pakistan, from Mar to Jun 2021. Methodology: Patients of COVID-19 age 18 and above, with a positive RT-PCR, were included in the study Clinical and radiological data of 200 patients was retrieved and analysed from the hospital registry. Results: In the present study, we studied the role of inflammatory markers in predicting the severity of COVID-19. We have compared the levels of LDH, CRP, IL-6 and serum Ferritin between the two groups. LDH (p=0.015), IL-6 (p=0.001) and Ferritin (p=0.001) were significantly different between the two groups, but CRP was not (p=0.811) significant. Conclusion: CT severity score associates well with the COVID-19 clinical severity. Our data suggest that the chest CT scoring system can predict the severity o...