The Predictive Value of Initial CT Scan in Patients with COVID-19

Abstract

Background: As the pandemic of coronavirus disease 2019 (COVID-19) in Wuhan raised public health concerns, many studies were conducted to reveal the risk factors of the disease and predictive prognostic indicators to plan the treatment strategies and commence therapies earlier. Although specific parameters, including age, gender, chronic diseases, D-dimer, and neutrophil-lymphocyte-ratio play a curial role in COVID-19, the association between mortality and the extent of lung involvement in the initial computerized tomography (CT) scan of patients diagnosed with COVID-19 has not been well documented in the literature. Objectives: We compared two groups (CT-1 and CT-2) in terms of lung involvement in the initial CT of patients admitted to the emergency unit and then hospitallzed with COVID-19. Methods: Using the digital data system of İzmir Bozyaka Training and Research Hospital, Turkey, subjects diagnosed with COVID-19 in April 2020 were retrospectively screened. For each of the 90 patients, the initial CT scans on admission were evaluated for the extent of lung involvement and classified as CT-1 (≤ 5% of lung involvement, n: 45) and CT-2 (> 5% of lung involvement, n: 45). Results: There was not any statistical significance between two different CT groups regarding mortality and length of stay of patients in hospital with COVID-19 (P = 0.72 and P = 0.51, respectively). Neutrophil counts were found to be statistically significant and higher in CT-2 group than the CT-1 (P = 0.02) group. The length of stay in hospital was correlated with age, neutrophil-lymphocyte ratio (NLR), neutrophils, lymphocyte, and only the correlation between length of stay in hospital and age was significant (P = 0.01). Conclusions: The size of involvement is not a predictive indicator for mortality and length of stay in hospital in patients with COVID-19.