Association of radiological severity with inflammatory biomarkers for prognostic prediction in patients with COVID-19

Abstract

Background Covid – 19 caused by SARS-CoV2 has become a pandemic. It has a rapid disease progression and causes severe and fatal complications. Associating radiological severity with effective biomarkers like CRP, leucocytes, lymphocytes, D – Dimer, would be helpful in screening, categorizing patient, preventing serious complications. Aims and Objectives The aim of the study was to investigate association between levels of inflammatory biomarkers and correlate it with HRCT chest finding to identify patients at risk of fatal complications. Materials and Methods It was a retrospective monocentric observational study undertaken at Ibn Tofail hospital COVID-19 dedicated center. 177 Patients>18 year of age who were admitted from september 1, 2020 up to november 30,2020 with laboratory confirmed diagnosis of Covid – 19 were included in the study. Data was collected on demography, disease severity, laboratory measurements, radiology imaging retrospectively from records of patients. The disease severity was classified into light, mild to severe and critic based on CT Severity scoring. HRCT Chest and inflammatory biomarkers were sent in every patient at the time of admission and the outcome was recorded. Results There were 116 male patients, 61 female patients in our study. Average age of patients having severe lung involvement is 61.9years, whereas Average age of patients having non-severe lung involvement is 56.8 years and showed significant association with severity of lung involvement (p value : 0.017). Severity of lung involvement according to HRCT chest findings was greater in patients with both raised values of CRP <0.001), D – Dimer (P value 0.032) and low values of lymphocytes (P value : 0.001). Capillary oxygen SATURATION was also found to be significantly associated with radiological severity among covid-19 patients. Compared with CRP, leukocytes, lymphocytes, and D-Dimeres levels, the CT severity score had higher sensitivity, specificity, and overall accuracy in predicting severe, critical cases, and short-term mortality. Conclusion the severity of Covid – 19 disease is correlated with radiological severity andinflammatory markers thereby it will help in immediate categorization of patients into different risk groups following diagnosis, to ensure optimal resource allocation.