Correlating CT severity score and laboratory parameters in COVID-19 patients: the Indian experience
DOI:
https://doi.org/10.18203/2320-6012.ijrms20220516Keywords:
As CT severity score, CRP, D-dimer, IL-6, Ferritin, LDHAbstract
Background: Patients with COVID-19 infection present with myriad of symptoms to the clinicians. Many of these patients undergo HRCT chest and various lab tests during their treatment. Correlation between various lab parameters and severity of the disease on chest CT would be helpful in management of such patients. In situations where CT is not available, lab parameters may help to predict disease severity. The primary objective was to find out if there was any correlation between CT severity scores and laboratory parameters in patients having COVID-19 and if one can be extrapolated in cases where CT facilities may not be available.
Methods: This is a retrospective, descriptive, and observational study. CT severity scores were obtained in all the patients using the 25 point scale. The following lab parameters were assessed: TLC, DLC, SGOT, SGPT, CRP, D-Dimer, IL-6, Serum Ferritin and serum LDH. Correlation was done between the CT score and various lab parameters using Pearson correlation coefficient test.
Results: 285 patients with positive COVID-19 RT-PCR test were included in the study. CT score showed statistically significant positive correlation with age, TLC, Neutrophil count, SGOT, SGPT, CRP, D-dimer, IL-6, Ferritin and LDH with p-values less than 0.05. Negative correlation was seen with Lymphocyte count. Severe disease was found to be more common in older patients.
Conclusions: In our study, CRP, LDH, Serum ferritin, IL-6 and D-dimer levels were observed to have positive correlation with disease severity on CT. Thus these measured at the time of admission can be taken into consideration to predict radiological severity.
References
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet. 2020;395(10223):497-506.
Time Course of Lung Changes at Chest CT during Recovery from Coronavirus Disease 2019 (COVID-19). Radiology. Available at: https://pubs.rsna.org/doi/full/10.1148/radiol.2020200370. Accessed on 12 November 2021.
Zhou S, Chen C, Hu Y, Lv W, Ai T, Xia L. Chest CT imaging features and severity scores as biomarkers for prognostic prediction in patients with COVID-19. Ann Transl Med. 2020;8(21):1449.
Francone M, Iafrate F, Masci GM, Coco S, Cilia F, Manganaro L, et al. Chest CT score in COVID-19 patients: correlation with disease severity and short-term prognosis. Eur Radiol. 2020;30(12):6808-17.
Correlation between Chest CT Severity Scores and the Clinical Parameters of Adult Patients with COVID-19 Pneumonia. Available at: https://www.hindawi.com/journals/rrp/2021/6697677/. Accessed on 12 November 2021.
Pan F, Ye T, Sun P, Gui S, Liang B, Li L, et al. Time Course of Lung Changes at Chest CT during Recovery from Coronavirus Disease 2019 (COVID-19). Radiology. 2020;295(3):715-21.
Yilmaz A, Sabirli R, Seyit M, Ozen M, Oskay A, Cakmak V, et al. Association between laboratory parameters and CT severity in patients infected with Covid-19: A retrospective, observational study. Am J Emerg Med. 2021;42:110-4.
Liu F, Li L, Xu M, Wu J, Luo D, Zhu Y, et al. Prognostic value of interleukin-6, C-reactive protein, and procalcitonin in patients with COVID-19. J Clin Virol Off Publ Pan Am Soc Clin Virol. 2020;127:104370.
Krishna BSG, Krishna PP, Sankar VR, Raghu K, Kumar AS, Srikanth M, et al. Laboratory Markers Versus Ct Severity Score In Predicting Mortality In Covid 19. Eur J Mol Clin Med. 2021;7(10):1824-31.
Chest CT manifestations with emphasis on the role of CT scoring and serum ferritin/lactate dehydrogenase in prognosis of coronavirus disease 2019 (COVID-19) | Egyptian Journal of Radiology and Nuclear Medicine. Available at: https://ejrnm.springeropen.com/articles/10.1186/s43055-021-00459-4. Accessed on 15 November 2021.
Comparative evaluation of semi-quantitative CT-severity scoring versus serum lactate dehydrogenase as prognostic biomarkers for disease severity and clinical outcome of COVID-19 patients. Egyptian Journal of Radiology and Nuclear Medicine. Available at: https://ejrnm.springeropen.com/articles/10.1186/s43055-021-00493-2. Accessed on 15 November 2021.
Yuan M, Yin W, Tao Z, Tan W, Hu Y. Association of radiologic findings with mortality of patients infected with 2019 novel coronavirus in Wuhan, China. PloS one. 2020;15(3):e0230548.