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Lung CT Segmentation to Identify Consolidations and Ground Glass Areas for Quantitative Assesment of SARS-CoV Pneumonia
Published on: December 19, 2020
Lymphopenia and lung complications in patients with coronavirus disease-2019 (COVID-19): A retrospective study based
Ehsan Zaboli1, Hadi Majidi2, Reza Alizadeh-Navaei1
1Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.
Insights
Lymphopenia (low lymphocyte count) and severe lung involvement on CT scans are linked to higher COVID-19 mortality. These factors together significantly increase the risk of death and prolonged hospitalization for patients.
Area of Science:
- Medical research
- Infectious diseases
- Pulmonology
Background:
- The COVID-19 pandemic caused by novel coronavirus has led to a global health crisis.
- Understanding predictors of severe outcomes in COVID-19 patients is crucial for effective management.
- Lymphopenia and specific computed tomography (CT) scan findings are potential indicators of disease severity.
Purpose of the Study:
- To investigate the association between lymphopenia, CT scan features, and COVID-19 patient mortality.
- To identify key indicators for predicting severe outcomes and in-hospital mortality in COVID-19 patients.
Main Methods:
- Retrospective analysis of clinical data from 596 COVID-19 patients.
- Evaluation of serological survey results and CT scan features.
- Statistical analysis to determine the association between lymphopenia, lung involvement, and mortality.
Main Results:
- Lymphopenia (lymphocyte count < 20%) and severe lung involvement (>50%) on CT scans were significantly associated with increased odds of death (OR, 9.24).
- These factors impose a multiplicative effect on mortality risk, leading to higher in-hospital mortality rates.
- Patients with both lymphopenia and severe lung involvement experienced significantly prolonged hospital stays.
Conclusions:
- Lymphocyte count below 20% and chest CT findings with over 50% involvement are significant indicators of COVID-19 mortality.
- These indicators can help assess disease severity, predict mortality, and guide patient management.
- Early identification of these markers may improve patient outcomes and resource allocation during the pandemic.
Abstract:
A rapid outbreak of novel coronavirus, coronavirus disease-2019 (COVID-19), has made it a global pandemic. This study focused on the possible association between lymphopenia and computed tomography (CT) scan features and COVID-19 patient mortality. The clinical data of 596 COVID-19 patients were collected from February 2020 to September 2020. The patients' serological survey and CT scan features were retrospectively explored. The median age of the patients was 56.7 ± 16.4 years old. Lung involvement was more than 50% in 214 COVID-19 patients (35.9%). The average blood lymphocyte percentage was 20.35 ± 10.16 (normal range, 20%-50%). Although the levels of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were high in more than 80% of COVID-19 patients; CRP, ESR, and platelet-to-lymphocyte ratio (PLR) may not indicate the in-hospital mortality of COVID-19. Patients with severe lung involvement and lymphopenia were found to be significantly associated with increased odds of death (odds ratio, 9.24; 95% confidence interval, 4.32-19.78). These results indicated that lymphopenia < 20% along with pulmonary involvement >50% impose a multiplicative effect on the risk of mortality. The in-hospital mortality rate of this group was significantly higher than other COVID-19 hospitalized cases. Furthermore, they meaningfully experienced a prolonged stay in the hospital (p = .00). Lymphocyte count less than 20% and chest CT scan findings with more than 50% involvement might be related to the patient's mortality. These could act as laboratory and clinical indicators of disease severity, mortality, and outcome.
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