Correlation between chest CT severity scores and clinical and biochemical parameters of COVID-19 pneumonia.

BACKGROUND: The COVID-19 pandemic, which first appeared in Wuhan, China, in December 2019 and spread rapidly around the globe, continues to be a serious threat today. Rapid and accurate diagnostic methods are needed to identify, isolate and treat patients as soon as possible because of the rapid contagion of COVID-19. In the present study, the relation of the semi-quantitative scoring method with computed tomography in the diagnosis of COVID-19 in determining the severity of the disease with clinical and laboratory parameters and survival of the patients were investigated along with its value in prognostic prediction. MATERIAL AND METHOD: A total of 277 adult patients who were followed up in the chest diseases clinic because of COVID-19 pneumonia between 11.03.2020 and 31.05.2020 were evaluated retrospectively in the present study. Both lungs were divided into five regions in line with their anatomical structures, and semiquantitative radiological scoring was made between 0 and 25 points according to the distribution of lesions in each region. The relations between semiquantitative radiological score and age, gender, comorbidity, and clinical and laboratory parameters were examined. RESULTS: A significant correlation was detected between advanced age, lymphopenia, low oxygen saturation, high ferritin, D-dimer, and radiological score in the univariate analysis performed in the present study. The cut-off value of the semiquantitative radiology score was found to be 15 (AUC: 0.615, 95% CI: 0.554-0.617, p = 0.106) in ROC analysis. The survival was found to be better in cases with a radiology score below 15, in Kaplan-Meier analysis (HR: 4.71, 95% CI: 1.43-15.46, p < 0.01). In the radiological score and nonparametric correlation analyses, positive correlations were detected between CRP, D-dimer, AST, LDH, ferritin, and pro-BNP, and a negative correlation was found between partial oxygen pressure and oxygen saturation (p = 0.01, r = 0.321/0.313/0.362/0.343/0.313/0.333/-0.235/-0.231, respectively) CONCLUSION: It was found that the scoring system that was calculated quantitatively in thorax HRCTs in Covid-19 patients is a predictive actor in determining the severity and prognosis of the disease in correlation with clinical and laboratory parameters. Considering patients who have a score of 15 and above with semiquantitative scoring risky in terms of poor prognosis and short survival and close follow-up and early treatment may be effective to reduce mortality rates.

Characteristics of hospitalised COVID-19 patients and parameters associated with severe pneumonia.

BACKGROUND: After the first case of coronavirus disease 2019 (COVID-19) was reported in China in December 2019, it caused a global pandemic, including Turkey. OBJECTIVES: The aim of this study was to analyse the characteristics of hospitalised COVID-19 patients and assess the parameters related to severe pneumonia. METHODS: Included in the study were hospitalised COVID-19 patients with positive naso-oropharyngeal swabs. Patients' demographics, admission symptoms, laboratory and radiological findings were recorded retrospectively. RESULTS: Of 1013 patients, 583 were males (57.6%) and 430 were females (42.4%), with a mean age of 53.7 ± 17.9. More than half of the patients had at least one comorbidities, the most common of which were hypertension and diabetes mellitus. Cough (59.8%), fatigue (49.5%) and fever (41.2%) were the most common presenting symptoms. Of the hospitalised COVID-19 patients, 84.9% had pneumonia and 83.5% had typical radiological COVID-19 appearances (94.5%: ground-glass areas). The most common laboratory findings were high C-reactive protein (CRP) (73.6%) and lactate dehydrogenase (LDH) (46.2%) levels, as well as lymphopenia (30.1%). Severe pneumonia was present in 28.1% of COVID-19 patients. Multivariate logistic regression analysis indicated that advanced age, hypotension, anaemia and elevated CRP and LDH serum levels were independent risk factors for the severity of COVID-19 pneumonia (P = .011, .006, .017, .003 and .001, respectively). CONCLUSION: This study, as one of the first multicentre studies about characteristics of COVID-19 in Turkey, may guide about disease-related parameters and severity of pneumonia. Age, blood pressure, complete blood count and routine biochemical tests (including CRP and LDH) would appear to be important parameters for the evaluation of the severity of COVID-19 pneumonia.

The impact of charlson comorbidity index on mortality from SARS-CoV-2 virus infection and A novel COVID-19 mortality index: CoLACD.

OBJECTIVE: The aim of this study is to find out the potential risk factors including charlson comorbidity index (CCI) score associated with death in COVID-19 patients hospitalised because of pneumonia and try to find a novel COVID-19 mortality score for daily use. METHODS: All patients diagnosed as confirmed or probable COVID-19 pneumonia whom hospitalised in our Chest Diseases Education and Research Hospital between March 11, 2020 and May 15, 2020 were enrolled. The optimal cut-off values, sensitivity and specificity values and odds ratios to be used in mortality prediction of the novel scoring system created from these parameters were calculated by ROC analysis according to the area under the curve and Youden index. RESULTS: Over 383 patients (n: 33 deceased, n: 350 survivors) univariate and multivariate regression analysis showed that CCI and lymphocyte ratio were prognostic factors for COVID-19-related mortality. Using this analysis, a novel scoring model CoLACD (CoVID-19 Lymphocyte ratio, Age, CCI score, Dyspnoea) was established. The cut-off value of this scoring system, which determines the mortality risk in patients, was 2.5 points with 82% sensitivity and 73% specificity (AUC = 0.802, 95% CI 0.777-0.886, P < .001). The risk of mortality was 11.8 times higher in patients with a CoLACD mortality score higher than 2.5 points than patients with a score lower than 2.5 (OR = 11.8 95% CI 4.7-29.3 P < .001). CONCLUSION: This study showed that by using the CoLACD mortality score, clinicians may achieve a prediction of mortality in COVID-19 patients hospitalised for pneumonia.

Clinical and laboratory findings of COVID-19

The pandemic of coronavirus disease-19 started in Wuhan City of China in December 2019 and quickly spread all over the world, infecting almost two million people. The clinical presentation of the disease is mild/moderate in 80% of cases;however, it leads to a critical clinical presentation by 20%, which is severe or very severe disease requires intensive care. The mortality is high, especially in cases with advanced age, comorbidities, and pneumonia-related acute respiratory distress syndrome and respiratory failure, while children are often with subclinical manifestations. The most common clinical findings are fever, cough, fatigue, and shortness of breath. The incubation period ranges from 2 to 14 days. The most common laboratory findings are lymphocytopenia and thrombocytopenia. Elevated D-dimer, ferritin, troponin I, lactate dehydrogenase and interleukin-6, and hypoxia (O-2 saturation <= 90%) were identified as "poor prognostic factors" associated with severe disease and mortality. The monitoring of such parameters was reported to be beneficial for determining patients with risk and potentially high mortality.