Koronavirus Hastalığında Yarı Kantitatif Görsel Skorlama ile Mortalite Öngörülebilir Mi?

AMAÇ: Çalışmamızda Bilgisayarlı tomografi (BT) ile yarı kantitatif bir puanlama yöntemi kullanarak COVID 19 prognozunu tahmin etmeyi amaçlamadık. GEREÇ VE YÖNTEMLER: 1 Nisan - 25 Haziran 2020 arasında 108 semptomatik COVID-19 hastası taburcu olana veya ölene kadar takip edildi. Akciğer anormalliklerinin paternleri ve dağılımı, toplam BT skorları ve tutulan lobların sayısı için BT görüntüleri değerlendirildi. Lober tutulumun kapsamına göre yarı kantitatif BT skoru hesaplandı (0:% 0; 1:% 5–25; 2:% 26–50; 3:% 51–75; 4,>% 75; aralık 0 –4;toplam puan 0–20). BT skorunun hastaların prognozu üzerindeki prediktif rolü istatistiksel olarak değerlendirildi. BULGULAR: Toplam BT skoru ortalama 7.47 ± 5.18 idi. 12 hastada BT’de herhangi bir parankimal tutulum görülmedi ve bu nedenle 0 olarak skorlandı. Her akciğer için loblar arasında karşılaştırmalar yapıldı. Sağ akciğerle ilgili olarak, ortalama BT skoru sağ alt lobda orta lobdan (p=0.001) ve üst lobdan (p=0.001) anlamlı olarak yüksekti; ortalama BT skoru sağ orta lobda üst loba göre anlamlı olarak daha yüksekti (p=0.001). Sol akciğerle ilgili olarak ortalama BT skoru sol alt lobda üst lobdan anlamlı olarak yüksekti (p=0.001). Sağ kalanlar grubunun total BT skoru ortalama 5.53±3.94 iken, mortalite grubunda 9.40±5.57 idi. Mortalite grubunun skoru sağ kalanlar grubuna göre anlamlı derecede yüksekti (p=0.001). SONUÇ: Görüntüleme özellikleri ve dinamik değişiklikler, hastalığın ciddiyetini ve prognozunu hesaplamak için doğrudan bilgi sağlayabilir. BT görüntülemeleri ile yapılan basit puanlama yöntemi, hastaların yönlendirilmesine, yakından izlenmeye veya agresif tedaviye ihtiyaç duyan hastaların belirlenmesine yardımcı olabilir.

Anahtar Kelimeler:

COVID-19, bilgisayarlı tomografi, skor, prognoz

Can Mortality Be Predicted with Semi-Quantitative Visual Scoring in Coronavirus Disease?

OBJECTIVE: The study was aimed to predict the COVID 19 prognosis using a semi-quantitative scoring method with computed tomography (CT). MATERIALS AND METHODS: From April 1 to June 25, 2020, 108 symptomatic COVID-19 patients were enrolled and followed up until they were discharged or died. CT scans were reviewed for the patterns and distribution of lung abnormalities, total CT scores and number of lobes involved. A semi-quantitative CT score was calculated based on the extent of lobar involvement (0:0%; 1:5–25%; 2:26–50%; 3:51–75%; 4, > 75%; range 0–4; global score 0–20). The predictive role of the CT score on the prognosis of the patients was evaluated statistically. RESULTS: The mean global CT score was 7.47±5.18. 12 patient did not show any parenchymal involvement at CT and was therefore scored as 0. Comparisons have been made between lobes for each lung. Regarding the right lung, mean CT score was significantly higher in right lower lobe than in middle lobe (p=0.001) and right upper lobe (p=0.001); mean CT score was significantly higher in right middle lobe than in upper lobe (p=0.001). Concerning the left lung, mean CT score was significantly higher in left lower lobe than in left upper lobe (p =0.001). Mean global CT score of survival group was 5.53±3.94, while mortal group was 9.40±5.57. The score of mortal group was significantly higher than survival group (p=0.001). CONCLUSION: The imaging features and dynamic changes could provide the most direct evidence for assessing the severity of the disease and the prognosis. Simple scoring method according to CT scans may help triage patients and screening patients who need more aggressive treatment and closely monitoring.

Keywords:

COVID-19, computed tomography, score, prognosis,

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