Learning from pathophysiological aspects of COVID-19 clinical, laboratory, and high-resolution CT features: a retrospective analysis of 128 cases by disease severity

• Published in: Emergency radiology Vol. 28; no. 3; pp. 453 - 467
• Main Authors: Azab, Sameh Mostafa, Zytoon, Ashraf Anas, Kasemy, Zeinab Abdel Aziz, Omar, Suzan Fouad, Ewida, Suzy Fayez, Sakr, Karim Ayman, Ella, Tarek Fawzy Abd
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.06.2021; Springer Nature B.V
• Subjects: Adolescent; Adult; Aged; Biomarkers - analysis; Chest; Computed tomography; Coronaviruses; COVID-19; COVID-19 - diagnostic imaging; Diagnosis; Dyspnea; Emergency Medicine; Female; High resolution; Humans; Imaging; Laboratories; Lymphocytes; Male; Medical imaging; Medicine; Medicine & Public Health; Middle Aged; Muscles; Muscular fatigue; Original; Original Article; Pandemics; Physicians; Pneumonia; Pneumonia, Viral - diagnostic imaging; Pneumonia, Viral - virology; Quality; Radiology; Retrospective Studies; SARS-CoV-2; Severity of Illness Index; Signs and symptoms; Tomography, X-Ray Computed; Transferrin; COVID-19 pneumonia; Pathophysiological; GGO; High-resolution CT
• ISSN: 1070-3004; 1438-1435
• DOI: 10.1007/s10140-020-01875-1

Background The classic chest CT imaging features of COVID-19 pneumonia have low specificity due to their similarity with a number of other conditions. So, the goal of the present study is to learn from the pathophysiology of COVID-19 clinical features, laboratory results, and high-resolution CT manifestations in different stages of disease severity to provide significant reference values for diagnosis, prevention, and treatment. Methods This was a multicentered study that included 128 patients. Demographic, clinical, and laboratory data, in addition to chest HRCT findings, were evaluated. According to chest HRCT features, radiologic scoring were grade 1 and 2 for mild grades of the disease, 3 and 4 for moderate grades of the disease, and 5 and 6 for severe grades of the disease. Results Patient clinical symptoms ranged between fever, dry cough, muscle ache (myalgia)/fatigue, dyspnea, hyposomia, sore throat, and diarrhea. Lymphocytes and WBCs were significantly lower in patients with severe COVID-19. A significant negative correlation was found with WBCs ( r  = − 0.245, P  = 0.005), lymphocytes% ( r  = − 0.586, P  < 0.001), RBCs ( r  = − 0.2488, P  = 0.005), Hb (gm/dl) ( r  = − 0.342, P  < 0.001), and HCT ( r  = − 0.377, P  < 0.001). Transferrin and CRP were significantly higher in moderate and severe COVID-19 than mild degree and showed a significant positive correlation with CT score ( r  = 0.356, P  < 0.001) and ( r  = 0.429, P  < 0.001), respectively. The most common CT features were peripheral pulmonary GGO and air space consolidation. Conclusion Clinical features, laboratory assessment, and HRCT imaging had their characteristic signs and performances. Correlating them can make it possible for physicians and radiologists to quickly obtain the final diagnosis and staging of the COVID-19 pneumonia.