Balık Ayşe Özlem, Yagci Buket, Balik Recep, Uncu Ulaş Yalim
Department of Radiology, Haydarpaşa Numune Education and Research Hospital, Istanbul, Turkey.
Department of Infectious Diseases and Clinical Microbiology, Haydarpaşa Numune Education and Research Hospital, Istanbul, Turkey.
Acta Clin Croat. 2024 Oct;63(2):260-274. doi: 10.20471/acc.2024.63.02.2.
The aim was to compare the computed tomography (CT) semi-quantitative severity scoring (CT-SS) system assessments of COVID-19 pneumonia on initial and follow-up examinations according to the presence of comorbidities. Of the 278 real-time reverse transcription-polymerase chain reaction positive patients, 108 with a follow-up CT scan were evaluated. Then, all CT images were independently reviewed for CT-SS analysis by two reviewers. Reviewers were unaware of the patient laboratory and clinical findings. A quarter of patients had negative findings on their initial CTs. Sixty-one (56.4%) patients showed progression. Disease progression was more frequently observed in patients with type 2 diabetes mellitus (DM) and malignancies (p=0.044 and p=0.019, respectively). Follow-up CTs of patients with comorbidities, especially those with cardiovascular disease (56.4%) and type 2 DM (70.0%), demonstrated an increased frequency of diffuse involvement. The white lung sign was more frequently observed in patients with malignancies (60.0%). In this study, COVID-19 patients with comorbidity showed a higher rate of disease progression than those without comorbidity. Patients with comorbidities more frequently had severe CT findings with high CT-SS. These findings may serve as a guide in the COVID-19 pneumonia follow-up and treatment.
目的是根据合并症的存在情况,比较新型冠状病毒肺炎(COVID-19肺炎)初次检查和随访检查时的计算机断层扫描(CT)半定量严重程度评分(CT-SS)系统评估结果。在278例实时逆转录聚合酶链反应阳性患者中,对108例进行了随访CT扫描评估。然后,两名阅片者对所有CT图像进行独立复查以进行CT-SS分析。阅片者不知道患者的实验室检查和临床结果。四分之一的患者初次CT检查结果为阴性。61例(56.4%)患者病情进展。在2型糖尿病(DM)和恶性肿瘤患者中更常观察到疾病进展(分别为p=0.044和p=0.019)。合并症患者,尤其是心血管疾病患者(56.4%)和2型DM患者(70.0%)的随访CT显示弥漫性受累的频率增加。恶性肿瘤患者中更常观察到白肺征(60.0%)。在本研究中,合并症的COVID-19患者疾病进展率高于无合并症患者。合并症患者更常出现严重的CT表现和高CT-SS。这些发现可为COVID-19肺炎的随访和治疗提供指导。