Correlation of laboratory and chest computed tomography findings with clinical severity of COVID-19 pneumonia
Sadullah Şimşek1, Funda Merve Çetin2, Akif İşlek3, Yusuf Atabay4
1Department of Radiology, Nusaybin State Hospital, Mardin, Turkey
2Department of Pulmonary Medicine, Nusaybin State Hospital, Mardin, Turkey
3Department of Otolaryngology-Head & Neck Surgery, Nusaybin State Hospital, Mardin, Turkey
4Department of Internal Medicine, Nusaybin State Hospital, Mardin, Turkey
Keywords: Chest computed tomography, COVID-19, ground-glass opacities, prognosis, viral pneumonia .
Objectives: The aim of this study was to investigate the correlation between clinical and laboratory findings of the disease and chest computed tomography (CT) features in patients diagnosed with novel coronavirus-2019 (COVID-19).
Materials and methods: The prospective study included a total of 53 patients (30 males, 23 females; mean age: 54.8±19.9 years; range, 17 to 96 years) who were hospitalized due to COVID-19 between March 2020 and May 2020. A detailed chest CT examination was performed to the patients during hospitalization by a blinded radiologist. The radiological findings were classified according to the literature and frequencies of ground-glass opacities, the number of lobe involvement, consolidation, and posterior lung involvement and bilateral pneumonia. The C-reactive protein (CRP) level was established as the laboratory criterion. The clinical manifestation and severity of the disease and health status of the patients during hospitalization were recorded by a blinded pulmonologist. The severity classification of the disease was classified as mild = 1, common = 2, severe = 3, and critical = 4.
Results: The mean CRP levels was 18.1±27.1 U/mL in the mild disease group (n=11) and 108±23.6 U/mL in the critical group (n=8) (p=0.001). The most common findings in the chest CT were ground-glass opacities (n=36, 67.9%). Six (11.3%) patients had no CT findings, while 43 (81.1%) patients had bilateral pneumonia. The presence of ground-glass opacities and consolidation exacerbated the classification of the disease significantly (p=0.001 and p=0.001, respectively). A significant positive correlation was found between age, CRP level, and the number of lobes with pneumonia and severity disease (p=0.049, p=0.001, and p=0.001, respectively; r=0.270, r=0.587, and r=0.625, respectively).
Conclusion: Multilobar involvement and consolidation in COVID-19 pneumonia significantly correlate with the clinical severity of the disease and laboratory findings. Therefore, widespread involvement in chest CT during hospitalization may be a warning for the clinician.