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Published on: December 19, 2020
Coronavirus Disease 2019: Hysteresis Effect of Chest CT and the Correlation with its Severity
1Department of Infectious Diseases, Ankang Central Hospital, 85 South Jinzhou Road, Ankang 725000, Shaanxi Province, China.
Insights
Chest CT scans in COVID-19 patients show a hysteresis effect, meaning lung improvements lag behind fever relief. Lower lymphocyte counts and oxygen saturation correlate with increased lung lesion severity.
Area of Science:
- Medical Imaging
- Pulmonology
- Infectious Diseases
Background:
- Coronavirus disease 2019 (COVID-19) significantly impacts lung health.
- Understanding the temporal relationship between clinical recovery and imaging findings is crucial for patient management.
Purpose of the Study:
- To investigate factors influencing chest computed tomography (CT) hysteresis in COVID-19 patients.
- To determine the relationship between imaging findings and disease severity.
Main Methods:
- Retrospective analysis of chest CT data from 166 COVID-19 patients across four hospitals.
- Assessment of lesion volume and calculation of hysteresis time post-fever relief.
- Multivariate regression analysis to identify correlations between lung lesions, lymphocyte count, and oxygen saturation.
Main Results:
- A hysteresis effect was observed, with chest CT improvements lagging behind fever relief.
- Increased percentage of lesion/total lung volume was associated with decreased peripheral blood lymphocyte count and transcutaneous oxygen saturation.
Conclusions:
- Pulmonary lesions in COVID-19 exhibit a hysteresis effect relative to fever resolution.
- Disease severity, indicated by lesion volume, may be linked to reduced lymphocyte counts and oxygen saturation.
Purpose:
The purpose of this study was to investigate the influencing factors for chest CT hysteresis and severity of coronavirus disease 2019 (COVID-19).
Methods:
The chest CT data of patients with confirmed COVID-19 in 4 hospitals were retrospectively analyzed. An independent assessment was performed by one clinician using the DEXIN FACT Workstation Analysis System, and the assessment results were reviewed by another clinician. Furthermore, the mean hysteresis time was calculated according to the median time from progression to the most serious situation to improve chest CT in patients after fever relief. The optimal scaling regression analysis was performed by including variables with statistical significance in univariate analysis. In addition, a multivariate regression model was established to investigate the relationship of the percentage of lesion/total lung volume with lymphocyte and other variables.
Results:
In the included 166 patients with COVID-19, the average value of the most serious percentage of lesion/total lung volume was 6.62, of which 90 patients with fever had an average hysteresis time of 4.5 days after symptom relief, with a similar trend observed in those without fever. Multivariate analysis revealed that lymphocyte count in peripheral blood and transcutaneous oxygen saturation decreased with the increase of the percentage of lesion/total lung volume.
Conclusion:
There is a hysteresis effect in the improvement of chest CT image relative to fever relief in patients with COVID-19. The pulmonary lesions may be related to the severity as well as decreased lymphocyte count or percutaneous oxygen saturation.
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