Association Between CT Finding Changes and Clinical Course in COVID-19 Patients: A Single Center Retrospective Study.

Abstract

Background: This study aimed to summarize the baseline and radiological characteristics of patients with COVID-19 and investigate the correlation between clinical outcomes and radiological findings in the first week after admission.

Materials and methods: A single-center retrospective study was carried out on confirmed cases of COVID-19 based on RT-PCR and chest CT scan findings according to Iran's National Guidelines for defining COVID-19 in patients admitted to Imam Hossein Hospital, Tehran, Iran. Baseline and chest CT scan characteristics of patients were investigated, and their correlation with the change in clinical outcome was reported.

Results: 72 patients (50%) with a mean age of 54.65±16.2 years were in two periods of time including the first day of diagnosis and 6.0±3.4 days later. Based on CT scan Severity Score (CTSS) changes (decrease/no change or increase) during the study, patients were divided into two groups of CTSS progression (n=47) and CTSS no-progression (n=25). Diabetes mellitus (20%) and hypertension (19.1%) were the most frequent comorbidities among the patients in the non-progression and progression groups, respectively. There was no significant difference in demographic features including age and gender, and comorbidities (P>0.05). On the first day of diagnosis, there was no significant difference in blood tests and radiological findings and the number of patients who managed out-patients or in-patients in both groups. However, on the second evaluation day, patients in the progression group had significantly higher CTSS in comparison with the non-progression group (13.11±4.7 vs. 9.48±4.2, P=0.003), and the clinical situation in 15 patients in progression changed from out-patient to in-patient (p=0.033). Only chest CT imaging score was a potential parameter associated with the change in clinical progression (P=0.030, RR=10.18, 95, CI=1.25-89.72).

Conclusion: Increasing CTSS is a strong predictor of worsening clinical outcomes during hospitalization in COVID-19 patients.