Relation of High Resolution Pulmonary CT Findings and Clinical Condition of COVID-19 Patients (original) (raw)
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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...
Journal of Chitwan Medical College, 2022
Background: The full extent of pulmonary damage and long-term prognosis due to severe COVID-19 pneumonia is still unclear. This study was aimed to characterize and compare changes in the radiological pattern of HRCT chest in severe COVID-19 pneumonia patients from admission to that of follow-up. Methods: This was a one-year prospective study done at Chitwan Medical College from April 2020 to April 2021. Total 56 patients with severe COVID-19 pneumonia who had at least one HRCT chest during admission and another during follow-up within 5 weeks. Based on the total number of days on systemic steroids, patients were separated into three follow-up groups. Statistical Package for Social Science version 20 was used for data input and descriptive analysis. Point estimate at 95% Confidence interval was calculated along with frequency and descriptive statistics. Results: The median CT severity index scores of follow-up HRCT chest improved from 14.5 to 10.0 in the 3rd week and from 16.0 to 11....
Inflammatory Burden and Persistent CT Lung Abnormalities in COVID-19 Patients
Inflammatory burden is associated with COVID-19 severity and outcomes. Residual computed tomography (CT) lung abnormalities have been reported after COVID-19. The aim was to evaluate the association between inflammatory burden during COVID-19 and residual lung CT abnormalities collected on follow-up CT scans performed 2–3 and 6–7 months after COVID-19, in severe COVID-19 pneumonia survivors. C-reactive protein (CRP) curves describing inflammatory burden during the clinical course were built, and CRP peaks, velocities of increase, and integrals were calculated. Other putative determinants were age, sex, mechanical ventilation, lowest PaO2/FiO2 ratio, D-dimer peak, and length of hospital stay (LOS). Of the 259 included patients (median age 65 years; 30.5% females), 202 (78%) and 100 (38.6%) had residual, predominantly non-fibrotic, abnormalities at 2-3 and 6-7 months, respectively. In age- and sex-adjusted models, best CRP predictors for residual abnormalities were CRP peak (odds rati...
Relationship between chest CT manifestations and immune response in COVID-19 patients
International Journal of Infectious Diseases, 2020
To study the correlations of lymphocytes and cytokines between changes of lung lesion volumes in patients with COVID-19, and to predict these correlations. Methods: 93 patients with COVID-19 were divided into mild and severe groups. The data of lymphocyte subgroups and cytokines were collected, the imaging characteristics were measured, and correlation analysis was performed to analyze the differences. Results: 60 mild and 33 severe patients were included. Lymphocyte subsets decreased in both groups. The reduction percentages of the absolute lymphocytes value in mild and severe groups were 32% and 64%, respectively. The lung CT lesion volume of all patients was 241.45 AE 282.92 cm 3 , among which the mild group was 151.29 AE 226.04 cm 3 , and the severe group was 405.38 AE 304.90 cm 3 , respectively. In critically ill patients, the decrease of the absolute value of CD4+ T cells and the increase of IL-6 levels are significantly correlated with the volume of lung lesions. Conclusions: The absolute values of CD3+, CD4+, and CD8+ T cells are lower in patients with COVID-19, while the levels of IL-6 and IL-10 are increased. The severity of lung lesions predicts poor clinical outcomes and may be a predictor of the transition from mild to severe.
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...
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.
Covid-19: Correlation of Early Chest Computed Tomography Findings With the Course of Disease
Journal of Computer Assisted Tomography, 2020
Objective: To investigate the role of chest computed tomography (CT) examinations acquired early after initial onset of symptoms in predicting disease course in coronavirus disease 2019. Methods: Two hundred sixty-two patients were categorized according to intensive care unit (ICU) admission, survival, length of hospital stay, and reverse transcriptase-polymerase chain reaction positivity. Mean time interval between the onset of symptoms and CT scan was 5.2 ± 2.3 days. Groups were compared using Student t test, Mann-Whitney U, and Fisher exact tests. Results: In the ICU (+) and died groups, crazy paving (64% and 57.1%), bronchus distortion (68% and 66.7%), bronchiectasis-bronchiolectasis (80% and 76.2%), air trapping (52% and 52.4%) and mediastinal-hilar lymph node enlargement (52% and 52.4%) were significantly more encountered (P < 0,05). These findings were correlated with longer hospital stays (P < 0.05). There were no differences between reverse transcriptase-polymerase chain reaction-positive and-negative patients except bronchiectasis-bronchiolectasis. Conclusion: Computed tomography examinations performed early after the onset of symptoms may help in predicting disease course and planning of resources, such as ICU beds.
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.