Radiological and Laboratory Findings of Patients with COVID-۱۹ Infection at the Time of Admission

Background & Objective: Diagnosis of coronavirus disease ۲۰۱۹ (COVID-۱۹) can be challenging, especially when the real­time quantitative reverse transcription polymerase chain reaction (RT-PCR) is not available or it is negative. In this study, we evaluated imaging and laboratory findings in a group of patients with a multidisciplinary diagnosis of COVID-۱۹ pneumonia. Methods: A total of ۱۶۳ patients with a clinical diagnosis of COVID-۱۹ pneumonia admitted to a specialised respiratory centre in Tehran, Iran were enrolled in this study. The distribution and characteristics of presenting radiological and laboratory findings were evaluated and the relationship to the outcome was investigated. Results: RT­PCR was positive in ۹۲ patients. The diagnosis of COVID-۱۹ in RT-PCR negative patients was made on clinical and radiological grounds (n=۷۱). Also, ۲۴ (۱۴.۷%) patients died. The common computed tomography (CT) scan findings included ground-glass (۹۴%) and consolidating opacification (۱۲%), mainly in the lower lobes (۹۰%). Peripheral and central lung changes were observed in ۹۰% and ۵۲% of patients, respectively. Lymphopenia, positive CRP, and raised LDH were present in ۳۲%, ۶۵%, and ۹۶% of cases, respectively. A raised LDH of >۵۰۰U/L was the best predictor of death in these patients (R۲=۰.۶۶۲۳; OR=۲۴.۴). Other markers of outcome were male gender, age (>۵۰ years), lymphopenia, and severe CXR changes. Conclusion: Diagnosis of COVID-۱۹ can be challenging, and a multidisciplinary approach is often needed. Whilst RT-PCR is the standard diagnostic test, a negative test should be interpreted with caution. Blood tests and imaging can be useful in the diagnosis, monitoring, and risk assessment in patients with COVID-۱۹. 

کلیدواژه ها:

COVID-۱۹ ، Radiology ، Laboratory findings ، CT scan ، Chest X-ray