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

BMC Infect Dis. 2021 Feb 8;21(1):157. doi: 10.1186/s12879-021-05855-9.

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.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • C-Reactive Protein / metabolism
  • COVID-19 / blood
  • COVID-19 / diagnosis*
  • COVID-19 / physiopathology*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Italy
  • Lung / diagnostic imaging*
  • Lung / pathology
  • Lymphocyte Count
  • Male
  • Middle Aged
  • Oxygen / blood
  • Procalcitonin / blood
  • Prognosis
  • Retrospective Studies
  • Severity of Illness Index
  • Tomography, X-Ray Computed

Substances

  • Procalcitonin
  • C-Reactive Protein
  • Oxygen