Original Article

The Extent of Lung Involvement Based on CT-Scores, Compared to Clinical Symptoms and Laboratory Findings in COVID-19 Patients

Abstract

Novel coronavirus disease 2019 (COVID-19) has become a public health concern with over 6.5 million cases and 390,000 deaths around the world. This research aimed to find an association between computed tomography (CT) scores and clinical and laboratory findings to estimate the extent of lung infection in patients with COVID-19. The study sample enrolled 129 patients diagnosed with COVID-19 from January to February 2020. The chest CT images and clinical data were reviewed, images were segmented and scored by the degree of involvement from 0 to 4, and the relationship between them and clinical and laboratory findings were analyzed statistically. This study included 74 men and 59 women with a mean age of 55.08 years. Different abnormalities were observed; the mean CT score was 8.52 (7.83 to 9.21) and the most frequent lesions were GGO and consolidation. Our results revealed significant differences between groups categorized by dyspnea, sore throat, and low oxygen saturation concerning CT scores. There was also a significant correlation between CT scores and WBC counts and CRP levels (P<0.05). The evidence from this study implies that clinical and laboratory data, such as CRP, dyspnea, lymphopenia, and symptom onset closely correspond to chest CT scores and may be employed as initial tools to estimate the extent of lung involvement in COVID-19 patients.

 

1. Li K, Wu J, Wu F, Guo D, Chen L, Fang Z, et al. The clinical and chest CT features associated with severe and critical COVID-19 pneumonia. Invest Radiol 2020;55:327-31.
2. Fang Y, Zhang H, Xie J, Lin M, Ying L, Pang P, et al. Sensitivity of Chest CT for COVID-19: Comparison to RT-PCR. Radiology 2020;296:E115-7.
3. Lin C, Ding Y, Xie B, Sun Z, Li X, Chen Z, et al. Asymptomatic novel coronavirus pneumonia patient outside Wuhan: The value of CT images in the course of the disease. Clin Imaging 2020;63:7-9.
4. Yang W, Yan F. Patients with RT-PCR-confirmed COVID-19 and Normal Chest CT. Radiology 2020;295:E3.
5. Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W, et al. Correlation of Chest CT and RT-PCR Testing for Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases. Radiology 2020;296:E32-40.
6. Xiong Y, Sun D, Liu Y, Fan Y, Zhao L, Li X, et al. Clinical and High-Resolution CT Features of the COVID-19 Infection: Comparison of the Initial and Follow-up Changes. Invest Radiol 2020;55:332-9.
7. Simpson S, Kay FU, Abbara S, Bhalla S, Chung JH, Chung M, et al. Radiological Society of North America Expert Consensus Statement on Reporting Chest CT Findings Related to COVID-19. Endorsed by the Society of Thoracic Radiology, the American College of Radiology, and RSNA-Secondary Publication. J Thorac Imaging 2020;35:219-27.
8. Ye Z, Zhang Y, Wang Y, Huang Z, Song B. Chest CT manifestations of new coronavirus disease 2019 (COVID-19): a pictorial review. Eur Radiol 2020;30:4381-9.
9. Zhao W, Zhong Z, Xie X, Yu Q, Liu J. Relation Between Chest CT Findings and Clinical Conditions of Coronavirus Disease (COVID-19) Pneumonia: A Multicenter Study. AJR Am J Roentgenol 2020;214:1072-7.
10. Bernheim A, Mei X, Huang M, Yang Y, Fayad ZA, Zhang N, et al. Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Duration of Infection. Radiology 2020;295:200463.
11. Agostini A, Floridi C, Borgheresi A, Badaloni M, Pirani PE, Terilli F, et al. Proposal of a low-dose, long-pitch, dual-source chest CT protocol on third-generation dual-source CT using a tin filter for spectral shaping at 100 kVp for CoronaVirus Disease 2019 (COVID-19) patients: a feasibility study. Radiol Med 2020;125:365-73.
12. Dangis A, Gieraerts C, Bruecker YD, Janssen L, Valgaeren H, Obbels D, et al. Accuracy and reproducibility of low-dose submillisievert chest CT for the diagnosis of COVID-19. Radiol Cardiothorac Imaging 2020;2:e200196.
13. Kang Z, Li X, Zhou S. Recommendation of low-dose CT in the detection and management of COVID-2019. Eur Radiol 2020;30:4356-7.
14. Liu D, Li L, Wu X, Zheng D, Wang J, Yang L, et al. Pregnancy and Perinatal Outcomes of Women With Coronavirus Disease (COVID-19) Pneumonia: A Preliminary Analysis. AJR Am J Roentgenol 2020;215:127-32.
15. Mahdavi A, Khalili N, Davarpanah AH, Faghihi T, Mahdavi A, Haseli S, et al. Radiologic management of COVID-19: preliminary experience of the Iranian Society of Radiology COVID-19 Consultant Group (ISRCC). Iran J Radiol 2020;17:e102324
16. Salehi S, Abedi A, Balakrishnan S, Gholamrezanezhad A. Coronavirus disease 2019 (COVID-19): a systematic review of imaging findings in 919 patients. AJR Am J Roentgenol 2020;215:87-93.
17. Shi H, Han X, Jiang N, Cao Y, Alwalid O, Gu J, et al. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect Dis 2020;20:425-34.
18. Wong HYF, Lam HYS, Fong AH, Leung ST, Chin TW, Lo CSY, et al. Frequency and Distribution of Chest Radiographic Findings in Patients Positive for COVID-19. Radiology 2020;296:E72-e8 19.
19. Wu J, Wu X, Zeng W, Guo D, Fang Z, Chen L, et al. Chest CT Findings in Patients With Coronavirus Disease 2019 and Its Relationship With Clinical Features. Invest Radiol 2020;55:257-61..
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IssueVol 61 No 2 (2023) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/acta.v61i2.12556
Keywords
Clinical Symptoms Computed Tomography COVID-19 Lung Infection
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Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Kamali A, Chehrei A, Hasanian M, Sofian M, Bahrami M, Khansarinejad B, Zarinfar N, Moradzadeh R, Sarmadian H, Safi F. The Extent of Lung Involvement Based on CT-Scores, Compared to Clinical Symptoms and Laboratory Findings in COVID-19 Patients. Acta Med Iran. 2023;61(2):109-114.