Evaluation of Pneumonia Severity and Lung Computed Tomography Findings in Covid-19 Patients

Melek Cihanbeylerden; Çağla Şafak; Cihat Tek; Muhammed Savran

doi:10.31067/acusaglik.1362545

Research Article

BibTex

RIS

Cite

Evaluation of Pneumonia Severity and Lung Computed Tomography Findings in Covid-19 Patients

Year 2024, , 194 - 203, 01.07.2024

Melek Cihanbeylerden , Çağla Şafak , Cihat Tek , Muhammed Savran

https://doi.org/10.31067/acusaglik.1362545

Abstract

Purpose: Early recognition of corona virus disease 2019 (COVID-19) cases is the key to reducing mortality. In this study, we aimed to describe the relationship between the clinical, laboratory, and lung computed tomography (LCT) characteristics of patients with COVID-19 pneumonia and determine the severity of pneumonia in these patients.
Methods: The pneumonia severity index (PSI) score system, LCT images, and laboratory parameters at the time of first presentation to the emergency department were examined to assess the severity of COVID-19 pneumonia in 225 adult patients.
Results: In this study, a significant relationship was found between COVID-19-associated mortality and male gender (p=0.045), advanced age (p<0.001), a high neutrophil count in peripheral blood (p<0.001), a low eosinophil count (p<0.001), 5-49% lung involvement on LCT (p<0.001), and PSI Groups IV and V (p<0.001).
Conclusion: Using the multivariate logistic regression analysis, we determined the most significant factors for mortality as advanced age, low eosinophil and lymphocyte counts, increased lactate and ferritin levels, and PSI Group V.

Keywords

Corona virus disease 2019, Pneumonia severity index, Computed tomography, Prognosis, Mortality

References

1. Loeffelholz MJ, Tang Y-W. Laboratory diagnosis of emerging human coronavirus infections–the state of the art. EMi, 2020;9(1):747-56. DOI: 10.1080/22221751.2020.1745095
2. Xu X-W, Wu X-X, Jiang X-G, et al. Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series. BMJ. 2020;368. DOI: 10.1136/bmj.m606
3. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239-42. DOI: 10.1001/jama.2020.2648
4. Pan L, Mu M, Yang P, et al. Clinical characteristics of COVID-19 patients with digestive symptoms in Hubei, China: a descriptive, cross-sectional, multicenter study. The AJG. 2020;115. DOI: 10.14309/ajg.0000000000000620
5. Li K, Wu J, Wu F, et al. The clinical and chest CT features associated with severe and critical COVID-19 pneumonia. Invest Radiol. 2020. DOI: 10.1097/RLI.0000000000000672
6. Liu R, Han H, Liu F, et al. Positive rate of RT-PCR detection of SARS-CoV-2 infection in 4880 cases from one hospital in Wuhan, China, from Jan to Feb 2020. CCA. 2020;505:172-5. DOI: 10.1016/j.cca.2020.03.009
7. Control CfD, Prevention. Research use only real-time RT-PCR protocol for identification of 2019-nCoV. 2020.
8. Wang S, Kang B, Ma J, et al. A deep learning algorithm using CT images to screen for Corona Virus Disease (COVID-19). ESR. 2021;31:6096-104. DOI: 10.1007/s00330-021-07715-1
9. Hansell DM, Bankier AA, MacMahon H, et al. Fleischner Society: glossary of terms for thoracic imaging. Radiol. 2008;246(3):697-722. DOI: 10.1148/radiol.2462070712
10. Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-9. DOI: 10.1001/jama.2020.1585
11. Guan W-j, Ni Z-y, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. NEJM. 2020;382(18):1708-20. DOI: 10.1056/NEJMoa2002032
12. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. DOI: 10.1016/ S0140-6736(20)30183-5
13. Li J, He X, Yuan Y, et al. Meta-analysis investigating the relationship between clinical features, outcomes, and severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia. AJIC. 2021;49(1):82-9. DOI: 10.1016/j.ajic.2020.06.008
14. Qin C, Zhou L, Hu Z, et al. Dysregulation of immune response in patients with coronavirus 2019 (COVID-19) in Wuhan, China. CID. 2020;71(15):762-8. DOI: 10.1093/cid/ciaa248
15. Taylor Jr FB, Toh C-H, Hoots KW, et al. Towards definition, clinical and laboratory criteria, and a scoring system for disseminated intravascular coagulation. JTH. 2001;86(11):1327-30. DOI: 10.1055/s-0037-1616068
16. Tang N, Li D, Wang X, et al. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. JTH. 2020;18(4):844-7. DOI: 10.1111/jth.14768
17. Zou Z, Yang Y, Chen J, et al. Prognostic factors for severe acute respiratory syndrome: a clinical analysis of 165 cases. CID .2004;38(4):483-9. DOI: 10.1086/380973
18. Colombi D, Bodini FC, Petrini M, et al. Well-aerated lung on admitting chest CT to predict adverse outcome in COVID-19 pneumonia. Radiol. 2020;296(2):E86-E96. DOI: 10.1148/radiol.2020201433
19. Wang Y, Dong C, Hu Y, et al. Temporal changes of CT findings in 90 patients with COVID-19 pneumonia: a longitudinal study. Radiol. 2020;296(2):E55-E64. DOI: 10.1148/radiol.2020200843
20. Bernheim A, Mei X, Huang M, et al. Chest CT findings in coronavirus disease-19 (COVID-19): relationship to duration of infection. Radiol. 2020;295(3):685-91. DOI: 10.1148/radiol.2020200463
21. Chon Y, Kim JY, Suh YJ, et al. Adverse initial CT findings associated with poor prognosis of coronavirus disease. J Korean Med Sci . 2020;35(34). DOI: 10.3346/jkms.2020.35.e316
22. Kim M-A, Park JS, Lee CW, et al. Pneumonia severity index in viral community acquired pneumonia in adults. PONE. 2019;14(3):e0210102. DOI: 10.1371/journal.pone.0210102