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Observational Study
. 2021 Feb 8;21(1):157.
doi: 10.1186/s12879-021-05855-9.

The association between clinical laboratory data and chest CT findings explains disease severity in a large Italian cohort of COVID-19 patients

Simone Canovi  1 , Giulia Besutti  2   3 , Efrem Bonelli  4   2 , Valentina Iotti  2 , Marta Ottone  5 , Laura Albertazzi  4 , Alessandro Zerbini  6 , Pierpaolo Pattacini  2 , Paolo Giorgi Rossi  5 , Rossana Colla  4 , Tommaso Fasano  4 ; Reggio Emilia COVID-19 Working Group;
Collaborators, Affiliations
Observational Study

The association between clinical laboratory data and chest CT findings explains disease severity in a large Italian cohort of COVID-19 patients

Simone Canovi et al. BMC Infect Dis. .

Abstract

Background: Laboratory data and computed tomography (CT) have been used during the COVID-19 pandemic, mainly to determine patient prognosis and guide clinical management. The aim of this study was to evaluate the association between CT findings and laboratory data in a cohort of COVID-19 patients.

Methods: This was an observational cross-sectional study including consecutive patients presenting to the Reggio Emilia (Italy) province emergency rooms for suspected COVID-19 for one month during the outbreak peak, who underwent chest CT scan and laboratory testing at presentation and resulted positive for SARS-CoV-2.

Results: Included were 866 patients. Total leukocytes, neutrophils, C-reactive protein (CRP), creatinine, AST, ALT and LDH increase with worsening parenchymal involvement; an increase in platelets was appreciable with the highest burden of lung involvement. A decrease in lymphocyte counts paralleled worsening parenchymal extension, along with reduced arterial oxygen partial pressure and saturation. After correcting for parenchymal extension, ground-glass opacities were associated with reduced platelets and increased procalcitonin, consolidation with increased CRP and reduced oxygen saturation.

Conclusions: Pulmonary lesions induced by SARS-CoV-2 infection were associated with raised inflammatory response, impaired gas exchange and end-organ damage. These data suggest that lung lesions probably exert a central role in COVID-19 pathogenesis and clinical presentation.

Keywords: COVID-19; Clinical laboratory; Computed tomography.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Coronal chest CT images representing the visual scoring system used to evaluate the degree of parenchymal involvement: < 20% (a), 20–39% (b), 40–59% (c), > = 60% (d). Parenchymal qualitative CT findings evaluated in this study were: ground-glass opacities (asterisks in panels a and d), consolidation (arrows in panel b), crazy-paving pattern (arrowheads in panel c)
Fig. 2
Fig. 2
The scheme summarizes the significant variations in laboratory data related to the extension of penumonia evaluated on CT scans
See this image and copyright information in PMC

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