Radiology, Department of Emergency, Tor Vergata University Hospital, Department of Surgical Science, University of Rome "Tor Vergata", Rome.
Department of Diagnostic and Interventional Radiology, General Hospital, Frosinone, Italy.
Medicine (Baltimore). 2021 Apr 9;100(14):e25310. doi: 10.1097/MD.0000000000025310.
To investigate the relationship between damaged lung assessed by chest computed tomography (CT) scan and laboratory biochemical parameters with the aim of finding other diagnostic tools.Patients who underwent chest CT for suspected Corona Virus Disease-2019 (COVID-19) pneumonia at the emergency department admission in the first phase of COVID-19 epidemic in Italy were retrospectively analyzed. Patients with both negative chest CT and absence of the novel coronavirus in nasopharyngeal or oropharyngeal real-time reverse transcriptase polymerase chain reaction (RT-PCR) swabs were excluded from the study. A total of 462 patients with positive CT scans for interstitial pneumonia were included in the study (250 males and 212 females, mean age 57 ± 17 years, range 18-89). Of these, 344 were positive to RT-PCR test, 118 were negative to double RT-PCR tests.CTs were analyzed for quantification of affected lung volume visually and by dedicated software. Statistical analysis to evaluate the relationship between laboratory analyses and CT patterns and amount of damaged lung related with COVID-19 pneumonia was performed in 2 groups of patients: positive RT-PCR COVID-19 group and negative RT-PCR COVID-19 group, but both with positive CT scans for interstitial pneumonia.Lymphocytopenia, C-reactive protein (CRP), lactate dehydrogenase (LDH), d-dimer, and fibrinogen increased levels occurred in most patients without statistically significant differences between the 2 groups with CT scans suggestive for COVID-19. In fact, in both groups the volume of lung damage was strongly associated with altered laboratory test results, even for patients with negative RT-PCR test.The decreased number of lymphocytes, and the increased levels of CRP, LDH, d-dimer, and fibrinogen levels are associated with SARS-CoV 2 related pneumonia. This may be useful as an additional diagnostic tool in patients with double negative RT-PCR assay and with highly suspected clinic and chest CT features for COVID-19 to isolate patients in a pandemic period.
为了研究胸部计算机断层扫描 (CT) 评估的肺部损伤与实验室生化参数之间的关系，目的是寻找其他诊断工具。回顾性分析了意大利 COVID-19 流行第一阶段在急诊科因疑似 2019 年冠状病毒病 (COVID-19) 肺炎而行胸部 CT 检查的患者。排除了胸部 CT 阴性且鼻咽或口咽实时逆转录聚合酶链反应 (RT-PCR) 拭子中新型冠状病毒阴性的患者。共纳入 462 例间质性肺炎 CT 阳性患者（男 250 例，女 212 例，平均年龄 57 ± 17 岁，范围 18-89 岁）。其中 344 例 RT-PCR 检测阳性，118 例双 RT-PCR 检测阴性。通过专用软件对 CT 进行视觉评估和定量分析。对 COVID-19 肺炎相关的实验室分析与 CT 模式和受损肺量之间的关系进行统计分析，将患者分为 2 组：RT-PCR 阳性 COVID-19 组和 RT-PCR 阴性 COVID-19 组，但均为 CT 扫描提示间质性肺炎阳性。淋巴细胞减少、C 反应蛋白 (CRP)、乳酸脱氢酶 (LDH)、D-二聚体和纤维蛋白原升高在大多数患者中发生，但两组间无统计学差异。实际上，在两组中，肺损伤的体积与改变的实验室检测结果密切相关，即使对于 RT-PCR 检测阴性的患者也是如此。淋巴细胞数量减少，CRP、LDH、D-二聚体和纤维蛋白原水平升高与 SARS-CoV2 相关肺炎有关。在双 RT-PCR 检测阴性且高度怀疑 COVID-19 的临床和胸部 CT 特征的患者中，这可能是一种有用的辅助诊断工具，以便在大流行期间对患者进行隔离。
