Comparative evaluation of semi-quantitative CT-severity scoring versus serum lactate dehydrogenase as prognostic biomarkers for disease severity and clinical outcome of COVID-19 patients

Abstract

Background Coronavirus disease 2019 pandemic causes significant strain on healthcare infrastructure and medical resources. So, it becomes crucial to identify reliable predictor biomarkers for COVID-19 disease severity and short term mortality. Many biomarkers are currently investigated for their prognostic role in COVID-19 patients. Our study is retrospective and aims to evaluate role of semi-quantitative CT-severity scoring versus LDH as prognostic biomarkers for COVID-19 disease severity and short-term clinical outcome. Results Two hundred sixty-six patients between April 2020 and November 2020 with positive RT-PCR results underwent non-enhanced CT scan chest in our hospital and were retrospectively evaluated for CT severity scoring and serum LDH level measurement. Data were correlated with clinical disease severity. CT severity score and LDH were significantly higher in severe and critical cases compared to mild cases (P value < 0.001). High predictive significance of CT severity score for COVID-19 disease course noted, with cut-off value ≥ 13 highly predictive of severe disease (96.96% accuracy); cut-off value ≥ 16 highly predictive of critical disease (94.21% accuracy); and cut-off value ≥ 19 highly predictive of short-term mortality (92.56% accuracy). CT severity score has higher sensitivity, specificity, positive, and negative predictive values as well as overall accuracy compared to LDH level in predicting severe, critical cases, and short-term mortality. Conclusion Semi-quantitative CT severity scoring has high predictive significance for COVID-19 disease severity and short-term mortality with higher sensitivity, specificity, and overall accuracy compared to LDH. Our study strongly supports the use of CT severity scoring as a powerful prognostic biomarker for COVID-19 disease severity and short-term clinical outcome to allow triage of need for hospital admission, earlier medical interference, and to effectively prioritize medical resources for cases with high mortality risk for better decision making and clinical outcome.

COVID-19 Biomarkers Comparison: Children, Adults and Elders

“…From 2003 to the present, a variety of coronaviruses have been identified in humans and animals, according to the literature. This kind of virus can easily spread from one person to another, resulting in infections of varying degrees, most commonly the common cold but also more severe infections [ 1 , 2 ].…”

Prognostic and discriminatory abilities of imaging scoring systems in predicting COVID‐19 adverse outcomes

“…Full‐text screening yielded 56 articles from which data was subsequently extracted (Figure 1). The characteristics of the included studies are presented in Table [11–63]. Most studies are retrospective, they have a wide distribution worldwide in Italy, Japan, China, Netherlands.…”

“…COVID-19, prognostic, scoring systems 1 | BACKGROUND Coronavirus disease 2019 (COVID- 19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a pandemic in more than 200 countries or areas affected to the point the World Health Organization declared it a public health emergency issue of international concern (PHEIC) [1,2].…”

“…COVID 19 imaging findings have been reported in lots of studies; however, the use of a combined prognostic and triage tool has not been explored yet [3]. The prognostic importance of imaging modalities and their role in the risk stratification of patients already diagnosed with COVID- 19 have not yet been established. COVID-19 results in severe acute respiratory distress syndrome (ARDS), multi-organ dysfunction syndrome and mortality, and while supportive care is the main line of treatment for noncritically ill patients at admission, many of the patients may deteriorate during hospitalization.…”

COVID-19 Inflammatory Markers and Vitamin D Relationship in Pediatric Patients

“…As of March 2020, due to the global spread and severity of the COVID-19 disease, the WHO has defined the outbreak of COVID-19 as a pandemic. COVID-19 infection is manifested by severe acute respiratory syndrome, which results in the admission of many patients, especially elders and people with comorbidities such as diabetes, heart or lung conditions, into intensive care units (ICU) [ 4 , 5 ].…”