Imaging and Laboratory Results as Predictors of the Course of COVID-19

TL;DR

Chest CT scans and lab tests at hospital admission can predict severe COVID-19 and the need for non-invasive ventilation.

Contribution

Identified that lung parenchyma involvement on CT scans is the strongest predictor of severe COVID-19 outcomes.

Findings

Lung parenchyma involvement over 50% on CT scans best predicts severe disease.

Lab results like elevated D-dimer, CRP, and IL-6 correlate with severe disease and ventilation needs.

Older age and more severe lung changes are linked to higher mortality and intubation rates.

Abstract

What are the main findings?
Inflammatory changes involving more than 50% of the lung parenchyma on chest CT scans proved to be the best predictor of severe COVID-19 disease.The results of imaging and laboratory tests are useful in predicting the need for non-invasive ventilation support.

Inflammatory changes involving more than 50% of the lung parenchyma on chest CT scans proved to be the best predictor of severe COVID-19 disease.

The results of imaging and laboratory tests are useful in predicting the need for non-invasive ventilation support.

What is the implication of the main finding?
Chest CT and laboratory tests should be performed upon hospital admission in patients with COVID-19Despite the decreased incidence of COVID-19 following the pandemic, early identification of patients at risk for severe infection remains essential.

Chest CT and laboratory tests should be performed upon hospital admission in patients with COVID-19

Despite the decreased incidence of COVID-19 following the pandemic, early identification of patients at risk for severe infection remains essential.

Background: COVID-19 most often affects the respiratory system and may manifest as acute respiratory failure requiring the use of non-invasive respiratory support (NIRS). The aim of this study was to find predictors based on laboratory results and chest computed tomography (CT) scans performed on admission to the hospital indicating the need for NIRS and predicting mortality after hospital discharge. Methods: We retrospectively analysed data from consecutive patients hospitalised in the Pulmonology Department of the Temporary COVID Hospital in Poznan from 1 February 2021 to 31 March 2022. Upon admission to the department, the patients underwent a series of laboratory blood tests and high-resolution chest CT scan. Results: The study group included 282 patients, with an average age of 60.0 ± 15.0 years. In total, 54 (53%) patients of 101 requiring NIRS died from various causes or required intubation. Patients who required NIRS were significantly older and had more severe changes in the lung parenchyma. They had higher white blood cell and neutrophil counts and lower lymphocyte counts, as well as higher concentrations of D-dimer, CRP, PCT, and IL-6 and greater activities of LDH and AST. Conclusions: Laboratory tests and chest CT performed on hospital admission may be useful to rapidly identify patients at higher risk for severe disease.

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