Correlations of CT scan with high-sensitivity C-reactive protein and D-dimer in patients with coronavirus disease 2019

Abstract

Objectives: To study the correlations of CT scan with high-sensitivity C-reactive protein (hs-CRP) and D-dimer in patients with coronavirus disease 2019 (COVID-2019).

Methods: From January to March 2020, COVID-19 patients were divided into two groups according to the Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (trial version 7), with mild and ordinary cases as Group-1 and critical and severe cases as Group-2. The chest CT scan results, hs-CRP, D-dimmer levels of the two groups from admission to discharge were compared by the χ² test or Fisher's exact test. The quantitative data were represented as mean ± standard deviation ( x ± s). Intergroup comparisons were performed by the independent samples t test, and the ineligible data were subjected to the nonparametric rank sum test. Binary logistic regression model was used for multivariate correlation analysis, using independent variables that were significant in univariate analysis. The correlations between the above indices were analyzed.

Results: In Group-1, there were two cases of normal chest CT scan results, one case of fibrosis, and 25 cases of abnormalities during the first diagnosis, mainly manifested as single or scattered ground-glass shadows. After treatment, the CT scan results became normal. The chest CT scan of Group-2 showed abnormalities, including 21 cases of multiple ground-glass shadows, and six cases of multiple consolidations accompanied by ground-glass shadows, who were critically ill and died. In addition, there were 16 cases of multiple ground glass shadows with partial consolidation, and the CRP and D-dimer levels of Group-2 were significantly higher than those of Group-1. Chest CT scan results were significantly positively correlated with CRP and D-dimer levels (P<0.05).

Conclusion: The chest CT scan results of COVID-19 patients are characteristic, being correlated with CRP and D-dimer levels. D-dimer and CRP levels significantly increase in most severe and critical patients, which are closely related to their prognosis. The indices may play predictive roles in clinical treatment and prognosis evaluation.

Keywords: D-dimer; coronavirus disease 2019; high-sensitivity C-reactive protein; pulmonary fibrosis.

Fig. 1

Chest CT scan results of a 53-year-old COVID-19 patient admitted after fever for 4 days. At admission, there were multiple ground-glass changes in both lungs. D-dimer level was 5.56 μg/ml, and hs-CRP level was 22.2 mg/L. He was given antiviral, immunity-enhancing and anticoagulant therapies.

Fig. 2

Chest CT scan results after 15 days of hospitalization. Multiple ground-glass lesions were observed, and pulmonary fibrosis was found locally. D-dimer and hs-CRP levels reduced to 0.62 μg/ml and 14.6 mg/L, respectively.