Chest CT Severity and Quantitative Lung Involvement Mirror Systemic Inflammation in Hospitalized COVID-19: A...

Area of Science:

• Radiology and Imaging
• Infectious Diseases
• Clinical Pathology

Background:

• COVID-19 presents with variable severity, necessitating objective assessment tools.
• Chest CT scans quantify lung involvement, while lab tests indicate systemic responses.
• Understanding the relationship between imaging and lab data is crucial for patient management.

Purpose of the Study:

• To investigate associations between quantitative CT-derived lung involvement metrics and laboratory biomarkers in hospitalized COVID-19 patients.
• To determine if CT findings correlate with systemic inflammatory, immunological, and metabolic markers.

Main Methods:

• A prospective multicenter cohort of 555 hospitalized COVID-19 adults was analyzed.
• Baseline low-dose chest CT and laboratory tests were performed within 24 hours of admission.
• CT Severity Score (CTSS), lesion volume, and percentage involvement were correlated with biomarkers using Spearman and multivariable regression.

Main Results:

• CTSS showed positive correlations with CRP, LDH, ferritin, fibrinogen, and D-dimer, and negative correlations with lymphocyte percentage and albumin.
• Lactate dehydrogenase (LDH) exhibited the strongest correlation (ρ = 0.68).
• LDH, glucose, creatinine, and lymphocyte percentage independently predicted CTSS, explaining approximately 40% of its variance.

Conclusions:

• CT-derived lung involvement metrics reflect the systemic disease burden in hospitalized COVID-19 patients.
• Combining quantitative CT data with laboratory biomarkers can enhance risk stratification.
• This integration may aid in optimizing clinical decision-making for COVID-19 management.