CT Severity Score Research Articles

Perbandingan CT-Scan thoraks pasien dengan infeksi COVID-19 varian Delta dan Omicron: sebuah systematic review

Background: During the COVID-19 pandemic, there have been a number of waves of infections that have resulted in a number of variants of concern (VoC), with the majority of the identified variants being the Delta and Omicron variants. A chest CT scan plays an important role in the diagnosis, complications, and prognosis of COVID-19 patients. This systematic review aims to compare chest CT scan images between COVID-19 patients infected with the Delta and Omicron variants. Methods: Study searches were conducted on three databases of electronic scientific journal publications, namely Google Scholar, PubMed, and Wiley Online Library. The study selection method used the PRISMA diagram with inclusion criteria are original study that examined a comparison of CT-scan images of the chest between COVID-19 patients with the Delta and Omicron variants. While the exclusion criteria set were studies in the form of commentaries, literature reviews, and meta-analyses, studies that were not available in Indonesian or English, and not available in full-text. Results: The ten studies included in this systematic review consisted of 10 retrospective cohort studies that compared CT-scan images of the chests of COVID-19 patients with Delta and Omicron variants. Radiological features evaluated from the ten studies included ground glass opacity (GGO), consolidation, crazy paving pattern, vascular dilation, air bronchogram, bronchial wall thickening, bronchiectasis, presence of reticulation, subpleural lines, fibrosis, halo sign, reverse halo sign (Atoll sign), air bubble sign, and presence of pleural effusion. The majority of these radiological features were found to be higher in the Delta variant compared to the Omicron. Whereas for the classification of chest CT scan images based on RSNA, typical images were also found more in the Delta variant. The CT severity score, CO-RADS score, and COV-RADS score were also found to be higher in the Delta variant compared to Omicron. Conclusion: In COVID-19 infection, the Delta variant showed a chest CT-scan showing typical COVID-19 pneumonia, whereas in the Omicron variant, more atypical features were found.

Comparison between abdominal CT findings in intensive care unit (ICU) and non-ICU patients with Covid-19: experience from a tertiary care hospital.

16-66% of COVID-19 positive patients may have abdominal symptoms and findings in abdominal CT. The yield of abdominal CT scan in patients having abdominal complaints is not known. The aim of this study was to explore the various abdominal imaging manifestations of COVID-19 and COVID-19 associated Mucormycosis (CAM) and to identify the relevant clinical and laboratory features associated with severity of the symptoms. A retrospective single centre observational study was performed at a tertiary care hospital in Northwest India. All consecutive patients who had COVID positive RT-PCR report and had undergone abdominal Computed Tomography scan from March 2020 to November 2021 for various abdominal complaints were included. Demographic data, CT images and reports and all relevant lab parameters were collected. Out of 75 patients, positive abdominal findings were seen in 65 patients. Hepatobiliary findings were seen in 41.3% (31 of 75; OR=1.9) and bowel abnormalities were found in 37.3% (28 of 75; OR=2.1) of COVID-19 patients. 7 patients who had renal infarcts or bowel ischemia were found to have COVID-19 associated Mucormycosis on histopathology. Chest CT severity score was positively correlated with most of the abdominal manifestations in patients requiring ICU admission. Elevated D-dimer levels were significantly associated with abdominal symptoms.

IL-6 and SAA-Strong Predictors for the Outcome in COVID-19 CKD Patients.

In this prospective study, we assessed biomarkers of inflammation (IL-6 and SAA) from the serum of 120 COVID-19 patients, of whom 70 had chronic kidney disease. All the samples were taken at emergency-department (ED) admission. Our goal was to relate the biomarkers to the results of death and acute kidney injury. All the patients underwent chest computer tomography to estimate the severity score (0-5), which was performed at hospital admission. Finally, biomarkers were also evaluated in a healthy control group and in non-COVID-19-CKD patients. IL-6 and SAA were statistically different between the subgroups, i.e., they were significantly increased in patients with COVID-19. Both of the biomarkers (IL-6 and SAA) were independently associated with mortality, AKI and a higher grade of pathological changes in the lung's parenchyma. Both high baseline levels of IL-6 and SAA on hospital admission were highly correlated with a later ventilatory requirement and mortality, independent of hospital stay. Mortality was found to be significantly higher when the chest CT severity score was 3-4, compared with a severity score of 0-2 (p < 0.0001). Conclusions: at the admission stage, IL-6 and SAA are useful markers for COVID-19 patients with CKD.

Chest Computed Tomography Characteristics of Critically Ill COVID-19 Patients with Auto-antibodies Against Type I Interferons

PurposePatients with auto-antibodies neutralizing type I interferons (anti-IFN auto-Abs) are at risk of severe forms of coronavirus disease 19 (COVID-19). The chest computed tomography (CT) scan characteristics of critically ill COVID-19 patients harboring these auto-Abs have never been reported.MethodsBicentric ancillary study of the ANTICOV study (observational prospective cohort of severe COVID-19 patients admitted to the intensive care unit (ICU) for hypoxemic acute respiratory failure between March 2020 and May 2021) on chest CT scan characteristics (severity score, parenchymal, pleural, vascular patterns). Anti-IFN auto-Abs were detected using a luciferase neutralization reporting assay. Imaging data were collected through independent blinded reading of two thoracic radiologists of chest CT studies performed at ICU admission (± 72 h). The primary outcome measure was the evaluation of severity by the total severity score (TSS) and the CT severity score (CTSS) according to the presence or absence of anti-IFN auto-Abs.ResultsTwo hundred thirty-one critically ill COVID-19 patients were included in the study (mean age 59.5 ± 12.7 years; males 74.6%). Day 90 mortality was 29.5% (n = 72/244). There was a trend towards more severe radiological lesions in patients with anti-IFN auto-Abs than in others, not reaching statistical significance (median CTSS 27.5 (21.0–34.8) versus 24.0 (19.0–30.0), p = 0.052; median TSS 14.5 (10.2–17.0) versus 12.0 (9.0–15.0), p = 0.070). The extra-parenchymal evaluation found no difference in the proportion of patients with pleural effusion, mediastinal lymphadenopathy, or thymal abnormalities in the two populations. The prevalence of pulmonary embolism was not significantly different between groups (8.7% versus 5.3%, p = 0.623, n = 175).ConclusionThere was no significant difference in disease severity as evaluated by chest CT in severe COVID-19 patients admitted to the ICU for hypoxemic acute respiratory failure with or without anti-IFN auto-Abs.

Effect of vaccination status on CORADS and computed tomography severity score in hospitalized COVID-19 patients: A retrospective study.

The coronavirus disease 2019 (COVID-19) pandemic is continuing. The disease most commonly affects the lungs. Since the beginning of the pandemic thorax computed tomography (CT) has been an indispensable imaging method for diagnosis and follow-up. The disease is tried to be controlled with vaccines. Vaccination reduces the possibility of a severe course of the disease. The aim of this study is to investigate whether the vaccination status of patients hospitalized due to COVID-19 has an effect on the CT severity score (CT-SS) and CORADS score obtained during hospitalization. The files of patients hospitalized between April 1, 2021 and April 1, 2022 due to COVID-19 were retrospectively reviewed. A total of 224 patients who were older than 18 years of age, whose vaccination status was accessible, whose severe acute respiratory syndrome coronavirus 2 polymerase chain reaction result was positive, and who had a Thorax CT scan during hospitalization were included in the study. Among the patients included in the study, 52.2% were female and the mean age was 61.85 years. The patients applied to the hospital on the average 7th day of their complaints. While 63 patients were unvaccinated (Group 1), 20 were vaccinated with a single dose of CoronaVac (Group 2), 24 with a single dose of BioNTech (Group 3), 38 with 2 doses of CoronaVac (Group 4), 40 with 2 doses of BioNTech (Group 5), and 39 with 3 doses of vaccine (2 doses of CoronaVac followed by a single dose of BioNTech, Group 6). CT-SS ranged from 5 to 23, with a mean of 12.17.CT-SS mean of the groups were determined as 14.17, 13.35, 11.58, 10.87, 11.28, 10.85, respectively. Accordingly, as a result of the comparisons between the groups, the CT-SS levels of the unvaccinated patients found to be significantly higher than the other groups. As the vaccination rates increased, the rate of typical COVID-19 findings on CT was found to be significantly lower. Increased vaccination rates in COVID-19 patients reduce the probability of typical COVID-19 symptoms in the lungs. It also reduces the risk of severe disease and decreases CT Severity Scores. This may lead to a loss of importance of Thorax CT in the diagnosis of COVID-19 pneumonia as the end of the pandemic approaches.

A Comparative Study of Lung Involvement Among Vaccinated and Unvaccinated Covid - 19 Patients

COVID-19 caused by a novel agent SARS-CoV-2 progressed to a pandemic condition and resulted in a major public health concern worldwide, leading to social and economic issues at the same time. Vaccinated people getting infected with SARS-COV2 brings a dilemma among the population whether to get vaccinated or not. The primary objective of this study is to evaluate the impact of vaccination by comparing the lung involvement in vaccinated and un vaccinated Covid – 19 patients. Retrospective anonymised data of COVID-19 inpatients who underwent HRCT scan during the second wave of pandemic were collected through a validated data collection form, from the medical records of tertiary care private medical college hospital. Vaccinated and non-vaccinated COVID-19 positive participants of 33 each were included in the study. CT severity score (CTS), D-dimer, IL-6 level, oxygen requirement and duration of hospital stay were statistically analysed using appropriate methods. The mean age of the study participants were 56.93 ± 16.01 years. There was no statistical significance between both the groups with respect to gender distribution in vaccinated and unvaccinated groups. There was a statistically significant difference in mean CTS score(p&lt;0.001) and oxygen requirement(p&lt;0.05) among vaccinated and unvaccinated patients. There was no statistical significance between CORADS, IL-6, D – Dimer and duration of hospital stay. In COVID-19 patients, vaccination reduces the extent of lung involvement and the need for oxygen. The COVID-19 vaccination conundrum is somehow resolved by this study, which also gives us a clear picture of the vaccine's efficacy. Keywords COVID­19, Vaccination, HRCT Scan, CORADS Severity

Impact of Hiatal Hernia on CT-Severity Scores and Survival of COVID-19 Patients

Impact of Hiatal Hernia on CT-Severity Scores and Survival of COVID-19 Patients

CHEST COMPUTED TOMOGRAPHY SEVERITY SCORING AND ITS RELATION WITH AGE AND GENDER DURING THE SECOND WAVE OF COVID-19 PANDEMIC – A RETROSPECTIVE AND OBSERVATIONAL STUDY

Objective: Our study aimed to assess the lung involvement using computed tomography (CT) severity scores and to determine how age and gender affect the severity of infection during the second wave of COVID-19. Methods: This retrospective and observational study was conducted in a dedicated COVID hospital. A total of 650 positive patients who gave their consent were included in this study. The CT severity score (25 points) was categorized as mild (&lt;7), moderate (7–18), and severe (&gt;18). Results: Patient’s age of 10–86 years with a mean and SD was 47.77±15.21 years, of which 440 were male and 210 were females. Males were more significantly affected than females (p=0.007). The mean±SD of CT severity score was 8.69±6.28, and ranging from 0 to 25. The most affected age group in the second wave of COVID-19 was 41–60 years (275 patients, 42.3%). A significant positive correlation between total CT severity with age, but it was mild (r=0.16, p=0.003). Conclusion: The age range with the highest CT severity score and the majority of men was 41–60 years. In addition, there was a strong association between the severity of the CT and both male gender and age.

MDCT and MRI in Bronchiectasis in Older Children and Young Adults- A Non-Inferiority Trial.

To compare and evaluate the usefulness of magnetic resonance imaging (MRI) with computed tomography (CT) in bronchiectasis; to compare MRI and CT scores with pulmonary function tests (PFT) and to evaluate the role of Diffusion-weighted imaging (DWI) in bronchiectasis. In this prospective study, 25 patients between 7-21 y of age with a clinical/radiological diagnosis of bronchiectasis underwent MDCT and MRI chest. MRI and CT scoring was performed using modified Bhalla-Helbich's score by two independent radiologists for all parameters. A final consensus score was recorded. The overall image quality of different MRI sequences to identify pathologies was also assessed. Appropriate statistical tests were used for inter-observer agreements, and correlation amongst CT and MRI; as well as CT, MRI and PFT. Strong agreement (ICC 0.80-0.95) between CT and MRI was seen for extent and severity of bronchiectasis, number of bullae, sacculation/abscess, emphysema, collapse/ consolidation, mucus plugging, and mosaic perfusion. Overall CT and MRI scores had perfect concordance (ICC 0.978). Statistically significant (p-value <0.01) intra-observer and inter-observer agreement for all CT and MRI score parameters were seen. A strong negative correlation was seen between total CT and MRI severity scores and forced expiratory volume in 1s (FEV1), forced vital capacity (FVC), forced expiratory flow (FEF) 25-75%. DWI MR, with an apparent diffusion coefficient(ADC) cut-off of 1.62 × 10-3 mm3/s had a sensitivity of 70% and specificity of 75% in detecting true mucus plugs. MRI with DWI can be considered as a radiation-free alternative in the diagnostic algorithm for assessment of lung changes in bronchiectasis, especially in follow-up.

Comparison of Chest Computed Tomography (CT) Imaging Patterns and Severity among COVID-19 Patients during the First and Fourth Waves in Addis Ababa, Ethiopia

Background. Studies done globally had shown that chest imaging patterns of Corona virus disease 2019 (COVID-19) infection varied depending on the strains of the virus and the waves of the pandemic. There is no published literature done in Ethiopia to examine whether there is any difference in chest computed tomography (CT) findings of COVID-19 patients during the first and fourth waves. Thus, this study tries to fill the gap of knowledge in that regard. Objective. To describe and compare chest CT scan imaging pattern and assess the predictors of chest CT severity of the first and fourth wave of COVID-19 infection. Methods. An institution-based cross-sectional study was conducted on 200 polymerase chain reaction test confirmed COVID-19 patients who underwent chest CT scan imaging in two diagnostic centers in Addis Ababa city. Pioneer and Wudassie diagnostic centers were selected due to the high case load and availability of well-experienced cardiothoracic radiologists. Data were collected from July 1 to August 3, 2022, using a structured Google form sheet questionnaire. Binary logistic regression was performed, and statistical significance was assessed at a level of significance α = 0.05. Results. Comparatively higher proportion of patients from the first wave had positive chest CT finding than fourth wave (99% vs. 69%). Bilateral lung involvement and lower lobe predilection were seen for both waves of COVID-19. Ground glass opacity and consolidation were the most common CT features for both waves. Delayed chest CT features such as traction bronchiectasis were primarily seen among first-wave patients. Mean global CT severity score was higher for the first-wave patients (13.18 vs. 8.31), and the mean difference is statistically significant ( p &lt; 0.001). Duration of symptoms was a statistically significant predictor of CT severity during the first wave of COVID-19, and patients that presented later than 14 days had 4.12 times higher odds of being in the severe CT score category than those that presented less than 7 days (AOR = 4.12, p = 0.011). There was no statistically significant predictor of CT severity for the fourth wave in this study. Conclusion. Chest CT positivity was comparatively higher for first wave patients. Common features included bilateral involvement, lower lobe involvement, ground glass opacity, and consolidation. Mean chest CT severity was comparatively higher for the first wave than the fourth wave, and the duration of symptoms was a statistically significant predictor of the CT severity for first wave.

Examining the potential risk factors for variable airflow limitation in patients recovering from SARS-CoV-2 Omicron variant infection: A case-control study

The Omicron strain of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread globally. However, it remains uncertain whether variable airflow limitation (VAL) occurs during the recovery phase after contracting the Omicron variant. To address this question, we conducted a study to examine the occurrence of VAL in patients infected with the Omicron variant (BA.1) of SARS-CoV-2, and we also investigated the potential risk factors associated with this phenomenon. We summarized and analyzed data taken from the electronic health records of recovering patients who had contracted the Omicron variant. The information was obtained from the Shuixi Branch of our Hospital during the period from January 22 to February 24, 2022. We focused on examining the occurrence of VAL and identifying the associated risk factors among these patients. In this case-control study, a total of 176 patients were enrolled. The occurrence of VAL was observed in 9.66% (17 individuals). Patients with VAL showed significantly elevated levels of the modified Borg dyspnea score, daytime cough score, night-time cough score, chest computed tomography severity score, and Treg ratio compared to those without VAL. Additionally, patients with VAL had a lower 6MWD value compared to those without it. Logistic regression analysis demonstrated that the modified Borg dyspnea score independently increased the risk of Omicron infection with VAL, with an odds ratio of 3.375, and a 95% confidence interval ranging from 1.537 to 7.408, with a P-value of .002. There is a possibility of experiencing VAL in certain patients recovering from the SARS-CoV-2 Omicron variant infection. The modified Borg dyspnea score has been identified as a standalone risk factor for the occurrence of VAL in SARS-CoV-2 Omicron infection.

Correlation between Chest Computed Tomography Severity Scores and Age of Adult Patients with Suspected Covid-19 Pneumonia Admitted in Intensive Care Unit of a Tertiary Care Hospital, Bangladesh

In Bangladesh, the second wave of Covid-19 was devastating. Mostly RT-PCR is used to determine the Covid-19 infection. But when test results are delayed, or when there is a clinical suspicion of Covid-19 despite initial negative RT-PCR testing, CT scan of chest was used to detect Covid-19 and Covid-19 severity. This observational cross-sectional study was carried out at Corona dedicated ICU of Bangabandhu Sheikh Mujib Medical College Hospital, Faridpur during February to June, 2021 to observe the HRCT severity score of the patient and its correlation with different ages. A total of 50 patients with clinically suspected Covid-19 cases who were admitted to the Corona dedicated ICU were included in the study. The chest HRCT images of study participants was gathered, CT severity score was calculated by a particular assignment radiologist. Based on this score; Severe disease was mainly seen in the &gt;60 year age group (50%). A significant moderate positive correlation was observed between age and CT chest severity score. With the increasing age the patients were suffering more and being male may increase the risk and put the patient to get admitted in the ICU, and as an alternative of the RT-PCR, CT scan of chest could be useful. Bangabandhu Sheikh Mujib Med. Coll. J. 2023;2(2):77-82

COVID-19 Vaccination Effectively Reduces Pneumonia Severity as Assessed by Routine Chest Computed Tomography

Background: In China, the COVID-19 outbreak infected more than 80% of the population. Few trials have been conducted to assess the effectiveness of the China-manufactured vaccine against COVID-19. Purpose: The purpose of this study was to evaluate the severity of pneumonia in individuals with COVID-19 who were fully vaccinated, partially vaccinated, and unvaccinated, using routine chest computed tomography. Materials and Methods: We analyzed data from patients (aged &gt;18 years) who were hospitalized due to COVID-19 pneumonia between December 2022 and January 2023. Patients who underwent routine chest CT scans were divided into three groups based on their vaccination status. The lobar involvement grading system (0-25) was used to assess the extent of lung injury. The primary outcome was either survival or death. The Pearson chi-square test, Fisher's exact test, and one-way ANOVA were used to compare clinical and imaging features. The receiver operating characteristic (ROC) curve analysis was used to calculate the area under the curve (AUC), sensitivity, and specificity of the CT severity score (CT-SS) in relation to the outcome. Results: Of the 94 patients with COVID-19 pneumonia, 39 patients (41%) were fully vaccinated, 14 (15%) were partially vaccinated, and 41 (44%) were unvaccinated. Among patients with COVID-19 pneumonia, the mean CT severity scores (CT-SS) were 5.9 ± 4.0, 6.5 ± 4.9, and 8.9 ± 4.5 for fully vaccinated individuals, partially vaccinated individuals, and unvaccinated individuals, respectively. The difference was statistically significant (p&lt;0.05). CT-SS of 10.5 or higher was associated with severe pneumonia (100% sensitivity, 81.1% specificity, and an area under the curve of 0.92). Conclusion: COVID-19 vaccination leads to less severe pneumonia based on CT. Fully and partially vaccinated patients with COVID-19 pneumonia have less lung involvement compared to unvaccinated patients. Visual observation by CT imaging provides additional evidence to support the clinical effectiveness of vaccination.

Extra pulmonary versus pulmonary presentation of COVID-19 patients: comparative study

BackgroundThe respiratory system is the most frequently affected system by COVID-19. However, a variety of extra-pulmonary systems can be influenced by COVID-19 with subsequent morbidity and mortality.AimThis study aim is to report the most frequent extra pulmonary presentations of COVID-19 with comparison to patients with primary pulmonary presentation. Risk factors for ICU admission in both groups were examined.MethodsIn this prospective comparative cross-sectional study, detailed demographics, medical history, clinical assessment, and computed tomography (CT) scan of the chest were done to all recruited patients with COVID-19.ResultThis study included a total of 1664 confirmed COVID-19 patients. The patients were categorized into two groups. Patients with pulmonary manifestations included 716 patients while 948 patients presented with extrapulmonary manifestations. Patients in the extrapulmonary group were older. The prevalence of certain chronic comorbid conditions was higher in the extra pulmonary group as cardiac, CNS, hepatic, and renal diseases, while chronic respiratory disorders were more prevalent in the pulmonary group (P value: < 0.0001). No significant difference in CT severity score between both groups. CORAD 5 was predominant in the pulmonary group (P value: < 0.0001). Most cases in both groups required hospital admission either inward or in ICU with higher frequency of ICU admission was observed in the pulmonary group. The significant risk factors for ICU admission in both groups were critically ill category of patients, CT severity, low oxygen saturation level, and the presence of comorbid chronic disease (P < 0.0001 with adjusted Odds ratio). CNS, cardiac, renal, and metabolic dysfunctions exert significant risk for ICU admission in the extrapulmonary group.ConclusionAtypical or non-respiratory manifestations could be the presentation of a respiratory pathogen as reported in COVID-19. Our work highlights the extrapulmonary presentation of COVID-19. Older male patients were more prone to present with extra pulmonary symptoms. CNS, cardiac, renal, and metabolic dysfunctions were the most affected systems. This could impact the level of care required for patient management and the extent of resource utility.

Physical and psychological symptom burden from long Covid and correlation with clinico-radiological and biochemical profile of hospitalized patients with acute COVID-19 due to Delta variant of SARS-CoV-2

Introduction and Aim: It is crucial to identify the burden of post COVID long-term morbidity denoted as long-COVID. Our study aims to determine prevalence of Long-COVID and to identify indicators which can predict chances of developing this condition. The aim was to study the persisting symptoms and predictors for long-COVID in COVID-19 patients. Materials and Methods: All patients hospitalized with acute COVID-19 infection from 1st April 2021 to 30th June 2021 with a positive RT-PCR were followed up through telephonic interview after 6 months of discharge. All clinical, laboratory, radiological data of patients during their hospital admission was retrieved from medical records. Current physical and psychological symptom burden (PHQ2 score) was recorded using a structured questionnaire and analysed. Results: Total of 101 patients were included. Mean age was 47yrs. M: F=2:1. Mean number of hospital stays was 7 days (1-34). Most patients needed admission on 5th day of illness (1-14). Mean CRP, D Dimer and Ferritin values were 77 mg/dl, 335 ng/ml, 414 microgram/ml respectively. Mean CT severity score was 12. The most common comorbidity was Type 2 Diabetes mellitus followed by hypertension. Of all patients, 16 % had symptoms of long COVID during 6 months post COVID infection. Most common symptoms were fatigue (60%), exercise intolerance (55%), cough (18%), breathlessness (18%), disturbed sleep quality (10%) and depression in 9.7% of patients as assessed by PHQ2 Score (1-6). None of the predictive factors were found to have statistically significant correlation with development of Long- COVID. Conclusion: Of all patients hospitalised with COVID-19, 16 % had long COVID symptoms at 6 months assessment. Majority had fatigue and exercise intolerance but one tenth also had depression. Multispecialty COVID follow up clinics are necessary for further assessment and rehabilitation of these patients.

Predicting Severe COVID-19 Infection on Initial Diagnosis: Comparison and Validation of CT Imaging Triage Tools.

Developing a reliable predictive tool of disease severity in COVID-19 infection is important to help triage patients and ensure the appropriate utilization of health-care resources. To develop, validate, and compare three CT scoring systems (CTSS) to predict severe disease on initial diagnosis of COVID-19 infection. One hundred and twenty and 80 symptomatic adults with confirmed COVID-19 infection who presented to emergency department were evaluated retrospectively in the primary and validation groups, respectively. All patients had non-contrast CT chest within 48 hours of admission. Three lobarbased CTSS were assessed and compared. The simple lobar system was based on the extent of pulmonary infiltration. Attenuation corrected lobar system (ACL) assigned further weighting factor based on attenuation of pulmonary infiltrates. Attenuation and volume-corrected lobar system incorporated further weighting factor based on proportional lobar volume. The total CT severity score (TSS) was calculated by adding individual lobar scores. The disease severity assessment was based on Chinese National Health Commission guidelines. Disease severity discrimination was assessed by the area under the receiver operating characteristic curve (AUC). The ACL CTSS demonstrated the best predictive and consistent accuracy of disease severity with an AUC of 0.93(95%CI:0.88-0.97) in the primary cohort and 0.97 (95%CI:0.91.5-1) in the validation group. Applying a TSS cut-off value of 9.25, the sensitivities were 96.4% and 100% and the specificities were 75% and 91% in the primary and validation groups, respectively. The ACL CTSS showed the highest accuracy and consistency in predicting severe disease on initial diagnosis of COVID-19. This scoring system may provide frontline physicians with a triage tool to guide admission, discharge, and early detection of severe illness.

Correlation of Inflammatory Markers with Computed Tomography Severity Scores in COVID-19 Patients

Correlation of Inflammatory Markers with Computed Tomography Severity Scores in COVID-19 Patients

The Acute Inflammatory Biomarkers - Are They Cost Effective and Real Time Early Predictors of Mortality in Acute Pneumonia? - A Prospective Observational Study

Introduction: The CT chest and investigations like IL6 and TNFɑ are the most accurate blood biomarkers of inflammatory changes and can be used to stage the severity and outcome of acute pneumonia. . Getting all the above mentioned investigations in a financially poor patients is not always possible. There are not much studies to look for the association between early raise in serum acute inflammatory bio markers and the prediction of mortality in acute pneumonia. So this study is under taken to know the association between significant raise in serum acute inflammatory biomarkers like hs CRP, LDH, ferritin, NLR, WBCs count in predicting the mortality of acute pneumonia in comparison with the serum IL6,q-SOFA score and CT chest severity score. Materials &amp; Method: All patients underwent standardized workup, including complete blood count, blood biochemistry, ferritin, hs-CRP, LDH,IL6,CT scan of chest ,q-SOFA score assessment and electrocardiogram. All the biochemical investigations were done on day 1 and day 5 of admission to the hospital. The patients were followed-up for the whole in hospital stay duration. Results: All the measured serum acute inflammatory bio markers, IL6, NLR, WBCs count, q-SOFA score and chest CT severity score were significantly elevated in patients with death due to acute pneumonia than the survived ones. [p value-0.01] Conclusion: This study proves that, the early raise in serum acute inflammatory biomarkers have got real and cost effective predictive value and are non-inferior to total WBCs count, NLR,IL6, q- SOFA score and chest CT severity score in assessing the mortality of acute pneumonia. Keywords: Acute Pneumonia, Acute inflammatory bio markers, CT scan of Chest, IL6, NLR (Neutrophils to Lymphocytes ratio), q-SOFA score, WBCs count

Diagnostic Performance Between Chest CT Severity Score and Initial Reverse Transcription-Polymerase Chain Reaction (RT-PCR) Cycle Values in COVID-19 Patients and Their Relation With the Clinical Status of Patients.

Reverse transcription-polymerase chain reaction (RT-PCR) is used as a standard test for the diagnosis of SARS-CoV-2 viral RNA from nasopharyngeal aspirates. However, this method lacks sensitivity and cannot assess disease severity. A CT scan of the thorax provides a CT severity score (CT-SS), which depicts lung involvement and disease severity. This study aims to investigate the diagnostic value of chest CT compared with RT-PCR cycle threshold (Ct) values in COVID-19 and relate it clinically with the disease severity of patients. This retrospective observational study was conducted in a tertiary center from April 2021 to March 2022. We included 511 patients who had tested RT-PCR positive for COVID-19, were hospitalized, and had undergone high-resolution CT (HRCT) thorax. Data was collected from patient records regarding name, age, sex, admission data, baseline investigations including Ct value, management, and outcome. HRCT was reviewed to assess lung involvement and calculate CT-SS. Data was analyzed using SPSS Statistics version 25 (IBM Corp. Released 2017. IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp.). The mean age of patients was 50.4 ± 13.7 years, and the majority (67.5%) were male. Gender-wise, there was no difference in RT-PCR cycle threshold (Ct) values; however, CT-SS was significantly higher in males (17.5 ± 4.8 vs.10.5 ± 6.6, t=-13.6, p<0.0001). ICU admission was needed for 34.8% of patients, and they had a significantly lower Ct value (21.7 ± 3.3 vs. 22.8 ± 3.7, t=21.10, p<0.0001) and higher CT-SS (16.3 ± 4.5 vs. 6.7 ± 5.1, t=-3.32, p=0.001). Ct values could not differentiate between moderate and severe patients. CT-SS was not related to the viral load at admission. Patients who succumbed had significantly lower Ct values and higher CT-SS.

Hepatosteatozun COVID-19 Hastalarında Göğüs BT Şiddet Skorlarının Seyrine Etkisi

Background/Aims: In the literature, the temporal variation of CT severity score (CT-SS) values on consecutive CTs, which is an indicator of pneumonia severity, according to the presence of hepatosteatosis was not evaluated. We aimed to investigate the effect of hepatosteatosis on the temporal change of CT-SS in COVID-19 patients. Material and Methods: Our retrospective study included 472 RT-PCR positive COVID-19 patients ( ≥ 18 years old) admitted to our hospital between December 2021 and January 2022. Chest CT severity scores ranging from 0 to 5 were assigned to each lobe of the lung and total CT-SS was obtained. For quantitative analysis, if the hepatic/splenic attenuation ratio was &amp;lt;1, hepatosteatosis was defined. Wilcoxon test was used to evaluate the temporal changes of CT-SS values relative to the presence of hepatosteatosis. p&amp;lt;0.05 was considered statistically significant. Results: Of the total 472 patients, 255/472 (54%) were hepatosteatosis-positive. The frequency of hepatosteatosis was significantly higher in male patients, 167/255 (65.5%) (p&amp;lt;0.001). The mean age was 64.04±14.35 years. There was no significant difference between ICU admission and hepatosteatosis groups (p=0.269). There was no significant difference between mortality and the presence of hepatosteatosis (p=0.429). There was a significant increase between the 1st and the 2nd CT-SS in patients with hepatosteatosis (p&amp;lt;0.001). The increase in the second CT-SS was higher in patients with hepatosteatosis than in patients without hepatosteatosis. Conclusion: Hepatosteatosis may be an indicator of poor prognosis in the temporal change of pneumonia severity in COVID-19 patients.