Relation of positive HRCT findings and levels of different inflammatory markers in COVID patients
DOI:
https://doi.org/10.1996/pjcm.v29i4.783Keywords:
COVID-19, HRCT, Lactate Dehydrogenase, C-reactive Protein, Interleukin-6Abstract
Background: COVID-19 is an acute infectious respiratory illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that spreads rapidly and causes the pandemic. High-resolution computed tomography (HRCT) chest, is a non-invasive and rapid method for diagnosing the disease and providing essential information regarding the evolution of COVID-19 pneumonia. Inflammatory markers have been an important method of assessing the severity of patients with COVID-19.Objective: The present study was conducted to find the relation between the HRCT findings and levels of different inflammatory markers and their trends in COVID-19 patients.Methodology: A prospective cross-sectional observational study was done on patients with COVID-19 in the Covid isolation unit, at Ayub Teaching Hospital Abbottabad, from 1st September 2021 to 30th November 2022. A total of 200 patients were evaluated for HRCT findings and systemic inflammatory markers levels. Data was collected prospectively on the basis of HRCT chest scans and inflammatory markers levels by using a bioproforma containing relevant variables. Data analysis was done by using SPSS 16 and results were drawn in the form of tables, figures, bar charts and scattered diagrams.Results: A total of 200 patients, with moderate to severe signs and symptoms of COVID-19 disease were evaluated. The age of patients ranges from 33 years to 87 years with a mean of 55 years. One hundred and five were males and 95 were females. Ninety patients had HRCT severity scores of 7-18 and 110 patients had HRCT severity scores of ≥ 19 out of 25. Serum levels of systemic inflammatory markers were raised in most of the patients. About 170 patients had CRP levels more than 100mg/dL, serum ferritin levels were raised (>1000ng/mL) in 165 patients, neutrophils to lymphocyte ratio was more than 1.5 in 166 patients, ALT levels were more than 100U/L in 161 patients, D-dimers levels were significantly increased in 154 patients and 150 patients had raised levels of IL-6 i.e. more than 44pg/mL. Procalcitonin levels were also raised i.e. more than 0.25ng/mL in 134 patients.Conclusions: The more involvement of lung lobes parenchyma with COVID-19 on HRCT, is associated with raised systemic inflammatory markers. Serum ALT, CRP, D-dimers, Neutrophils to lymphocytic ratio, IL-6 and ferritin levels were significantly raised in most of the patients with HRCT findings of severe lung lobes involvement.References
Alsharif W, Qurashi A. Effectiveness of COVID-19 diagnosis and management tools: A review. Radiography. 2021;27(2):682-7.
Corman VM, Landt O, Kaiser M, Molenkamp R, Meijer A, Chu DK, Bleicker T, Brünink S, Schneider J, Schmidt ML, Mulders DG. Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR. Eurosurveillance. 2020;25(3):2000045.
Fang Y, Zhang H, Xie J, Lin M, Ying L, Pang P, Ji W. Sensitivity of chest CT for COVID-19: comparison to RT-PCR. Radiology. 2020;296(2):E115-7.
Saeed GA, Gaba W, Shah A, Al Helali AA, Raidullah E, Al Ali AB, Elghazali M, et al. Correlation between chest CT severity scores and the clinical parameters of adult patients with COVID-19 pneumonia. Radiol Res Prac. 2021;2021:1-7.
Sun D, Li X, Guo D, Wu L, Chen T, Fang Z, Chen L, Zeng W, Yang R. CT quantitative analysis and its relationship with clinical features for assessing the severity of patients with COVID-19. Korean J Rad. 2020;21(7):859.
Zhou X, Pu Y, Zhang D, Xia Y, Guan Y, Liu S, Fan L. CT findings and dynamic imaging changes of COVID-19 in 2908 patients: a systematic review and meta-analysis. Acta Radiol. 2022;63: 291–310.
Mahat RK, Panda S, Rathore V, Swain S, Yadav L, Sah SP. The dynamics of inflammatory markers in coronavirus disease-2019 (COVID-19) patients: A systematic review and meta-analysis. Clin Epidemiol Glob Health 2021;11:100727.
Zhu T, Wang Y, Zhou S, Zhang N, Xia L. A comparative study of chest computed tomography features in young and older adults with corona virus disease (COVID-19). J Thorac Imaging. 2020; 35(4):W97-101.
Tan C, Huang Y, Shi F, Tan K, Ma Q, Chen Y, et al. C-reactive protein correlates with computed tomographic findings and predicts severe COVID-19 early. Clin Chim Acta. 2020;506:145-148.
Li YX, Wu W, Yang T, Zhou W, Fu YM, Feng QM, et al. Characteristics of peripheral blood leukocyte differentialcounts in patients with COVID-19. Chinese J Intern Med. 2020; 59(5):372-4.
Sun D, Li X, Guo D, Wu L, Chen T, Fang Z, et al. CT Quantitative Analysis and Its Relationship with Clinical Features for Assessing the Severity of Patients with COVID-19. Korean J Radiol 2020; 21:859-68.
Yang R, Li X, Liu H, Zhen Y, Zhang X, Xiong Q, et al. Chest CT Severity Score: An Imaging Tool for Assessing Severe COVID-19. Radiol Cardiothorac Imaging 2020; 2:e200047.
Volanakis, JE. Human C - reactive protein: Expression, Structure, and Function. Mol Immunol. 2001;38:189–97.
Sanli DE, Altundag A, Kandemirli SG, Yildirim D, Sanli AN, Saatci O, et al. Relationship between Disease Severity and Serum IL-6 Levels in COVID-19 Anosmia Am J Otolaryngol. 2021;42:102796.
Lucijanic M, Cicic D, Stoos-Veic T, Pejsa V, Lucijanic J, Dzankic AF, et al. Elevated Neutrophil-to-Lymphocyte-Ratio and Platelet-to-Lymphocyte Ratio in Myelofibrosis: Inflammatory Biomarkers or Representatives of Myeloproliferation Itself? Anticancer Res. 2018;38 (5):3157-63;.
Tao M, Zheng D, Liang X, He Q, Zhang W. Diagnostic Value of Procalcitonin for Bacterial Infections in Patients Undergoing Hemodialysis: A Systematic Review and Meta-Analysis. Ren Fail. 2022;44(1):81–93.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Pakistan Journal of Chest Medicine
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
