COVID-19-Related Lung Involvement at Different Time Intervals: Evaluation of Computed Tomography Images With Semiquantitative Scoring System and COVID-19 Reporting and Data System Scoring

Abstract

Introduction: This study aimed to evaluate the frequency of typical and atypical thoracic CT findings in patient groups diagnosed during different periods of the pandemic, examine disease severity using radiological scoring methods, and determine the relationship between atypical CT findings and disease severity.Materials and methods: One hundred fifty-one patients with positive reverse transcription polymerase chain reaction (RT-PCR) test and thoracic CT scan were included in the study. The patients were divided into two groups as group 1 (March to August 2020) diagnosed in the first six months of the pandemic and group 2 (September 2020 to February 2021) diagnosed in the second six months. CT images of the patients were analyzed for the frequency of typical and atypical findings. Evaluation was made in terms of disease suspicion and severity by scoring methods, and the relationship between atypical findings and disease severity was examined.Results: There was no statistically significant difference between the frequency and distribution patterns of typical CT findings observed in both groups. The most common atypical finding in both groups was nodular lesions. Central distribution, one of the atypical findings, was not seen in group 1, whereas it was present in nine patients in group 2 (p=0.001). The mean CT severity score was higher in group 2, and there was a statistically significant difference between the mean CT scores of both groups (p<0.001). In addition, six (7.2%) patients in group 1 and 34 (50%) patients in group 2 had CT scores above the cut-off value (p<0.001). There was no statistically significant relationship between atypical findings and severity score.Conclusion: Other diseases and atypical findings that may accompany COVID-19 pneumonia may increase the rate of misdiagnosis. In the diagnosis of the disease, clinical signs and symptoms and radiological findings should be evaluated together, and it should be kept in mind that lung findings in thorax CT change over time.

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Characteristics and Prognostic Factors of Pulmonary Fibrosis After COVID-19 Pneumonia

“…To date, few studies have reported on the follow-up of patients hospitalized for COVID-19 pneumonia (5,6). Different approaches based on disease severity have been proposed with the aim to standardize patients' follow-up.…”

“…Some recent studies tried to characterize radiological sequelae after COVID-19 pneumonia (5,6). This condition, which is referred to as "post-COVID syndrome, " still lacks a universally agreed definition (7).…”

COPD, but Not Asthma, Is Associated with Worse Outcomes in COVID-19: Real-Life Data from Four Main Centers in Northwest Italy

“…To assess the progress of the disease during hospitalization, the following parameters were collected and analyzed: Length of hospital stay, calculated from the day of admission for signs or symptoms related to SARS-CoV-2 to the day of discharge or demise; the presence of respiratory failure [ 21 , 22 ], evaluated by measuring the arterial P/F ratio; the presence of a COVID-19 pneumonia [ 23 , 24 , 25 ], assessed by chest HRTC; the need for ventilatory support (O2 in nasal cannula (NC), high flow nasal cannula (HFNO), Non-invasive Ventilation (NIV), Invasive Mechanical Ventilation (IMV)); therapies carried out during hospitalization, including systemic corticosteroids, hydroxychloroquine, monoclonal antibodies (tocilizumab, baricitinib) and antiviral drugs (Remdesivir, Lopinavir or Ritonavir) [ 26 ]; type of discharge: discharge (at home or in the facility) or death.…”