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Correlation of CT staging and biochemical parameters in assessing disease severity and mortality of COVID-19 patients

Kalpana Radhakrishnan, Thangalakshmi Adaikkalam, Rajendran Velayutham, Karthick Rajendran.


CT chest has become the front-line investigation even for a Real-time polymerase chain reaction (RT-PCR) negative patient due to low viral load. Many grading systems were formulated to assess the severity of lung involvement and combined with inflammatory markers like ferritin (Fr) and C reactive protein (CRP) to provide a guide for diagnosing and managing COVID patients.
After being tested with RT-PCR, Severe acute respiratory syndrome coronavirus -2(SARS-CoV-2) patients who were referred for CT were included in our study. A non-contrast CT scan of the chest was obtained with 16 slice -Toshiba with 1mm collimation. Findings documented included the presence and extent of ground glass opacities; consolidation whether round, linear, patchy, lobar, or diffuse; septal thickening; and other features of pre-existing diseases like cavity, bronchiectasis, pleural effusion, and cardiomegaly. CT staging was done based on the progress of the disease and compared with biochemical parameters.
Results: 571 patients; between the ages of 19 and 88 suspected to have Coronavirus pneumonia were included in the study. CT stages were compared with the median value of LDH, Fr, TGL, AND CRP All biochemical parameters LDH 692 (438.5 -771 ) (p-value 0.0001), Fr 1.27 (0.64 -1.89) (p-value 0.0001), and CRP (113.4 (95.5 2-207.7 ) (p-value 0.0001), were elevated in higher CT stages. Both elevated biochemical parameters and higher CT stages were associated with the severity and mortality of the disease. No significant p-value was noted with TGL.
Covid 19 pneumonia starts as a respiratory infection but spreads to become a systemic disease. The inflammation is associated with an increase in biochemical parameters which correlate with the staging of the lung by CT and in dead patients.

Key words: Computed tomography, Real-time polymerase chain reaction, biochemical parameters, SARS-CoV-2

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