Abstract
BackgroundLaboratory data and computed tomography (CT) have been used during the COVID-19 pandemic, mainly to determine patient prognosis and guide clinical management. The aim of this study was to evaluate the association between CT findings and laboratory data in a cohort of COVID-19 patients.MethodsThis was an observational cross-sectional study including consecutive patients presenting to the Reggio Emilia (Italy) province emergency rooms for suspected COVID-19 for one month during the outbreak peak, who underwent chest CT scan and laboratory testing at presentation and resulted positive for SARS-CoV-2.ResultsIncluded were 866 patients. Total leukocytes, neutrophils, C-reactive protein (CRP), creatinine, AST, ALT and LDH increase with worsening parenchymal involvement; an increase in platelets was appreciable with the highest burden of lung involvement. A decrease in lymphocyte counts paralleled worsening parenchymal extension, along with reduced arterial oxygen partial pressure and saturation. After correcting for parenchymal extension, ground-glass opacities were associated with reduced platelets and increased procalcitonin, consolidation with increased CRP and reduced oxygen saturation.ConclusionsPulmonary lesions induced by SARS-CoV-2 infection were associated with raised inflammatory response, impaired gas exchange and end-organ damage. These data suggest that lung lesions probably exert a central role in COVID-19 pathogenesis and clinical presentation.
Highlights
Laboratory data and computed tomography (CT) have been used during the COVID-19 pandemic, mainly to determine patient prognosis and guide clinical management
The proportion of patients over 60 years of age increased with increasing parenchymal extension evaluated by CT imaging, going from 39.2% in individuals with extension < 20 to 62.7% in cases with extension ≥60%
Each individual qualitative finding was associated with the degree of lung involvement: ground-glass opacities (GGO) were observed in 92.3% of patients with parenchymal extension < 20% and in 100% of patients with extension ≥60%; likewise, the proportion of patients with consolidation increased from 55.2 to 73.1% (Table 1)
Summary
Laboratory data and computed tomography (CT) have been used during the COVID-19 pandemic, mainly to determine patient prognosis and guide clinical management. The aim of this study was to evaluate the association between CT findings and laboratory data in a cohort of COVID-19 patients. In Italy, due to the overwhelming hospital influx of patients by the end of February 2020, there was serious concern regarding the national health system’s capacity to cope with severely infected subjects who required intensive care for the management of SARS-CoV-2-related pneumonia [1]. Laboratory data and CT scans have been used in the setting of COVID-19 pandemic, peripherally as part of the diagnostic work-up, but mostly to help define patient prognosis and to guide clinical management. A potential prognostic role of chest CT findings, especially the extent of parenchymal involvement, has been proposed [3,4,5,6]
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