The relationship of extent of initial radiological involvement with the need of intensive care, mortality rates, and laboratory parameters in Covid-19

The relationship of extent of initial radiological involvement with the need of intensive care, mortality rates, and laboratory parameters in Covid-19

Background/aim: It is very important for the efficient use of limited capacity and the success of treatment to predict patients who may need ICU with high mortality rate in the Covid-19 outbreak. In our study, it was aimed to investigate the value of the radiological involvement on initial CT in demonstrating the ICU transfer and mortality rate of patients. Materials and methods: All PCR-positive patients were included in the study, whose CT, PCR, and laboratory values were obtained simultaneously at the time of first admission. Patients were divided into 4 groups in terms of the extent of radiological lesions. These groups were compared in terms of intensive care transfer needs and Covid-related mortality rates. Results: A total of 477 patients were included in the study. Ninety of them were group 0 (no lung involvement), 162 were group 1 (mild lesion), 89 were group 2 (moderate lesion), and 136 were group 3 (severe lung involvement). A significant relationship was found between the extensiveness of the radiological lesion on CT and admission to intensive care and mortality rate. As the initial radiological involvement amounts increased, the rate of ICU transfer and mortality increased. The mortality rates of the groups were 0%, 3%, 12.3%, and 12.5%, respectively, and the difference was significant (p < 0.001). Similarly, the ICU transfer rates of the groups were 2.2%, 5.6%, 13.5%, and 17.7%, respectively, and the difference was significant (p < 0.001). Conclusion: In conclusion, in our study, the strong relationship between the initial radiological extent assessment and the need for intensive care and mortality rates has been demonstrated, and we believe that our results will make a significant contribution to increase the success of the health system in predicting patients who may progress, helping clinicians and managing pandemics.Key words: Covid-19, extensiveness of radiological lesions, intensive care, mortality rate

___

  • 1. Zhou F, Yu T, Du R, Fan G, Liu Y et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020; 395 (10229):1 054-1062. doi: 10.1016/S0140-6736(20)30566-3
  • 2. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in china: summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention. Journal of the American Medical Association 2020; 323 (13): 1239-1242. doi: 10.1001/jama.2020.2648
  • 3. Grasselli G, Pesenti A, Cecconi M. Critical care utilization for the COVID-19 outbreak in Lombardy, Italy: early experience and forecast during an emergency response. Journal of the American Medical Association 2020; 323 (16): 1545-1546. doi: 10.1001/jama.2020.4031
  • 4. Henry BM, de Oliveira MHS, Benoit S, Plebani M, Lippi G. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis. Clinical Chemistry and Laboratory Medicine 2020; 58 (7): 1021-1028. doi: 10.1515/cclm-2020-0369
  • 5. Zhao W, Zhong Z, Xie X, Yu Q, Liu J. Relation between chest CT findings and clinical conditions of coronavirus disease (COVID-19) pneumonia: a multicenter study. American Journal of Roentgenology 2020; 214 (5): 1072-1077. doi: 10.2214/AJR.20.22976
  • 6. Ai T, Yang Z, Hou H, Zhan C, Chen C et al. Correlation of chest CT and RT-PCR testing for coronavirus disease 2019 (COVID-19) in China: a report of 1014 cases. Radiology 2020; 296 (2): E32-E40. doi: 10.1148/radiol.2020200642
  • 7. Salehi S, Abedi A, Balakrishnan S, Gholamrezanezhad A. Coronavirus disease 2019 (COVID-19): a systematic review of imaging findings in 919 patients. American Journal of Roentgenology 2020; 215 (1): 87-93. doi: 10.2214/AJR.20.23034
  • 8. Tian W, Jiang W, Yao J, Nicholson CJ, Li RH et al. Predictors of mortality in hospitalized COVID-19 patients: a systematic review and meta-analysis. Journal of Medical Virology 2020; 92 (10): 1875-1883. doi: 10.1002/jmv.26050
  • 9. Izcovich A, Ragusa MA, Tortosa F, Lavena Marzio MA et al. Prognostic factors for severity and mortality in patients infected with COVID-19: a systematic review. PLoS One 2020; 15 (11): e0241955. doi: 10.1371/journal.pone.0241955
  • 10. Bwire GM, Majigo MV, Njiro BJ, Mawazo A. Detection profile of SARS-CoV-2 using RT-PCR in different types of clinical specimens: a systematic review and meta-analysis. Journal of Medical Virology 2020; 24: 10.1002/jmv.26349. doi: 10.1002/ jmv.26349
  • 11. Deeks JJ, Dinnes J, Takwoingi Y, Davenport C, Spijker R et al. Antibody tests for identification of current and past infection with SARS-CoV-2. The Cochrane Database of Systematic Review 2020; 6 (6): CD013652. doi: 10.1002/14651858. CD013652
  • 12. Cao Y, Liu X, Xiong L, Cai K. Imaging and clinical features of patients with 2019 novel coronavirus SARS-CoV-2: A systematic review and meta-analysis. Journal of Medical Virology 2020; 92 (9): 1449-1459. doi: 10.1002/jmv.25822
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
Sayıdaki Diğer Makaleler

Does previous open or percutaneous renal stone surgery affect retrograde intrarenal surgery outcomes?

Melih BALCI, Yılmaz ASLAN, Özer GÜZEL, Can AYKANAT, Ahmet ASFUROĞLU

The study of sirtuins in breast cancer patients before and after radiotherapy

Eser KILIÇ, Oğuz Galip YILDIZ, Hatice SARAÇOĞLU, Nazlı HELVACI

Sodium valproate improves sensorimotor gating deficit induced by sleep deprivation at low doses

Fatma Duygu KAYA YERTUTANOL, İ. Tayfun UZBAY, Burcu ÇEVRELİ, Asil Ali ÖZDOĞRU, Muhammet TEKİN, Hamza KULAKSIZ

Treatment of hypothyroidism improves glomerular filtration rate (GFR) in geriatric patients

Oktay BULUR, Derun Taner ERTUĞRUL, Kürşat DAL, Zeliha Günnur DİKMEN, Cafer BALCI, Mustafa CANKURTARAN, Burcu BALAM DOĞU, Meltem Gülhan HALİL, Mert EŞME, Mehmet Can ATAK

Effect of nondipper hypertension on coronary artery disease progression in patients with chronic coronary syndrome

Nihat KALAY, Deniz ELÇİK, Şaban KELEŞOĞLU, Zeki ÇETİNKAYA, Sibel BOYLU, Rıdvan YURT, Ali DOĞAN, Mehmet Tuğrul İNANÇ, Mustafa DURAN

The effect of different levels of pneumoperitoneum pressures on regional cerebral oxygenation during robotic assisted laparoscopic prostatectomy

Mutlu ATEŞ, Kerem İNANOĞLU, Sadık ÖZMEN, Ali Sait KAVAKLI, Arzu KARAVELİ, Murat ÖZÇELİK

Evaluation of ambulance calls for patients over 65 years of age in İzmir, Turkey: a twoyear retrospective analysis

Başak BAYRAM, Erkan GÜVENÇ, Ahu PAKDEMİRLİ

Genistein suppresses the inflammation and GSK-3 pathway in an animal model of spontaneous ovarian cancer

Cemal ORHAN, Engin YENİCE, Kazım ŞAHİN, Füsun ERTEN, Beşir ER, Pınar DEMİREL ÖNER, Patrick Brice DEFO DEEH

Clinical and molecular findings in 37 Turkish patients with isolated methylmalonic acidemia

Serdar CEYLANER, Fatma Derya BULUT, Berna ŞEKER YILMAZ, Sebile KILAVUZ, Halise Neslihan ÖNENLİ MUNGAN, Deniz KÖR

Comparison of local infiltration analgesia and interscalene block for postoperative pain management in shoulder arthroscopy: a prospective randomized controlled trial

Semih BAŞKAN, Güzelali ÖZDEMİR, Alper DEVECİ, Olgun BİNGÖL, Enver KILIÇ, Emrah ARSLANTAŞ