Some inflammatory markers and chest computerized tomography in patients with severe acute respiratory syndrome coronavirus infection

Akyüz, Aydın; Özçağlayan, Tuğba İlkem Kurtoğlu; Şahin, Gülcan Gücer; Efe, Muhammet Mucip; Gür, Demet Özkaramanlı; Alpsoy, Şeref

doi:10.1590/1806-9282.20200938

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Revista da Associação Médica Brasileira

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Original Article • Rev. Assoc. Med. Bras. 67 (4) • Apr 2021 • https://doi.org/10.1590/1806-9282.20200938 copy

Some inflammatory markers and chest computerized tomography in patients with severe acute respiratory syndrome coronavirus infection

Authorship SCIMAGO INSTITUTIONS RANKINGS

SUMMARY

OBJECTIVE:

We retrospectively assessed whether there was a relationship between lung complications and some easily accessible markers to predict the presence of pulmonary consolidation in patients with coronavirus disease 2019 (COVID-19).

METHODS:

According to the polymerase chain reaction and chest computerized tomography results, the study was categorized into three groups. Group 1 (n=87) included the patients with polymerase chain reaction (+), group 2 (n=55) included the patients with polymerase chain reaction (-) and chest computerized tomography (+), and group 3 (n=77) included the patients with polymerase chain reaction (-) and chest computerized tomography (-), respectively.

RESULTS:

High-sensitivity C-reactive protein and increased age were associated with higher computerized tomography (CT) scores.

CONCLUSION:

Increased age and C-reactive protein (CRP) may suggest pulmonary infiltration on chest CT in patients with COVID-19.

KEYWORDS:
Coronavirus disease 2019; X-ray computed tomography; Diagnosis; C-reactive protein

	Group 1 n=87	Group 2 n=55	Group 3 n=77	p-value
Age, years	49(19–84)	56(20–87)	52(25–86)	0.081
Gender, male, n (%)	38(43.7)	32(58.2)	44(57.1)	0.065
Hypertension, n (%)	15(17.2)	22(40)	24(31.2)	0.037^a a for comparing group 1 vs 2 ,^b b for comparing group 1 vs 3
Hyperlipidemia, n (%)	8(9.1)	4(7.3)	10(13)	0.284
Smoking, n (%)	40(46)	31(56.4)	24(31.2)	0.052
Diabetes Mellitus, n (%)	13(14.9)	32(21.8)	8(10.4)	0.384
Fever, n (%)	41(47.1)	28(50.9)	2(2.6)	<0.001^b b for comparing group 1 vs 3 ,^c c for comparing group 2 vs 3
Dyspnea, n (%)	22(25.3)	23(41.8)	1(1.3)	<0.001^a a for comparing group 1 vs 2 ,^b b for comparing group 1 vs 3 ,^c c for comparing group 2 vs 3
Cough, n (%)	55(63.2)	31(56.4)	3(0.4)	<0.001^b b for comparing group 1 vs 3 ,^c c for comparing group 2 vs 3
Headache, n (%)	7(8)	4(7.3)	1(1.3)	0.047^b b for comparing group 1 vs 3 ,^c c for comparing group 2 vs 3
Sore throat, n (%)	14(16.1)	6(10.9)	1(1.3)	0.001^b b for comparing group 1 vs 3 ,^c c for comparing group 2 vs 3
Diarrhea, n (%)	4(4.6)	0	0	0.077
Hospitalization time, day	8.5(0–62)	6(2–48)	3(2–8)	0.034^b b for comparing group 1 vs 3 ,^c c for comparing group 2 vs 3
Mean CT scores	4(0–15)	4(1–16)	0	0.029^b b for comparing group 1 vs 3 ,^c c for comparing group 2 vs 3
CT lesion presence	28(32.1)	55(100)	0	<0.001^a a for comparing group 1 vs 2 ,^b b for comparing group 1 vs 3 ,^c c for comparing group 2 vs 3
Intubation, n (%)	8(9.2)	5(9.1)	0	<0.001^b b for comparing group 1 vs 3 ,^c c for comparing group 2 vs 3
Death, n (%)	5(5.7)	4(7.3)	0	<0.001^b b for comparing group 1 vs 3 ,^c c for comparing group 2 vs 3
Hemoglobin, gr/dL	13.3±2.1	13.2±1.9	13.5±1.7	0.475
Red cell width	14.4±1.7	14.6±2.5	13.9±1.9	0.057
WBC, x10⁹9. Huang H, Liu Q, Zhu L, Zhang Y, Lu X, Wu Y, et al. Prognostic value of preoperative systemic immune-inflammation index in patients with cervical cancer. Sci Rep. 2019;9(1):3284. https://doi.org/10.1038/s41598-019-39150-0 https://doi.org/10.1038/s41598-019-39150... /L	6.2±3.1	9.1±4.9	7.5±2.6	0.001^a a for comparing group 1 vs 2 ,^c c for comparing group 2 vs 3
Neutrophils, x10⁹9. Huang H, Liu Q, Zhu L, Zhang Y, Lu X, Wu Y, et al. Prognostic value of preoperative systemic immune-inflammation index in patients with cervical cancer. Sci Rep. 2019;9(1):3284. https://doi.org/10.1038/s41598-019-39150-0 https://doi.org/10.1038/s41598-019-39150... /L	3.3(0.1–14.2)	6(1.32–17.5)	3.9(1.5–11.8)	0.022^b b for comparing group 1 vs 3 ,^c c for comparing group 2 vs 3
Lymphocytes, x10⁹9. Huang H, Liu Q, Zhu L, Zhang Y, Lu X, Wu Y, et al. Prognostic value of preoperative systemic immune-inflammation index in patients with cervical cancer. Sci Rep. 2019;9(1):3284. https://doi.org/10.1038/s41598-019-39150-0 https://doi.org/10.1038/s41598-019-39150... /L	1.5±1.1	1.61±1.3	2.22±1.4	0.007^b b for comparing group 1 vs 3 ,^c c for comparing group 2 vs 3
Platelets, x10⁹9. Huang H, Liu Q, Zhu L, Zhang Y, Lu X, Wu Y, et al. Prognostic value of preoperative systemic immune-inflammation index in patients with cervical cancer. Sci Rep. 2019;9(1):3284. https://doi.org/10.1038/s41598-019-39150-0 https://doi.org/10.1038/s41598-019-39150... /L	209±92	249±101	251±78	0.006^a a for comparing group 1 vs 2 ,^b b for comparing group 1 vs 3
MPV	8.9±1.9	8.6±0.8	8.6±1.1	0.278
N/L ratio	2.31(0.2–16.7)	3.1(0.9–17)	1.94(0.3–17.2)	0.001^a a for comparing group 1 vs 2 ,^b b for comparing group 1 vs 3 ,^c c for comparing group 2 vs 3
SII	437(30–3,000)	750(209–3,107)	465(89–5,437)	<0.001^a a for comparing group 1 vs 2 ,^c c for comparing group 2 vs 3
Hs-CRP, mg/dL	11.1(0.5–293)	38(0.3–323)	2.3(011–147)	<0.001^a a for comparing group 1 vs 2 ,^b b for comparing group 1 vs 3 ,^c c for comparing group 2 vs 3
D dimer, mg/dL	0.55(0.2–188)	0.68(0.2–21)	0.62(0.19–1.27)	0.228
eGFR, mL/min/1.73m²2. Cheval S, Adamescu CM, Georgiadis T, Herrnegger M, Piticar A, Legates DR. Observed and potential impacts of the COVID-19 pandemic on the environment. Int J Environ Res Public Health. 2020;17(11):4140. https://doi.org/10.3390/ijerph17114140 https://doi.org/10.3390/ijerph17114140...	97±23	90±25	94±21	0.241
AST, IU/L	25(12–306)	24(14–432)	17.6(8–48)	0.001^a a for comparing group 1 vs 2 ,^c c for comparing group 2 vs 3
ALT, IU/L	21(0–172)	24(9–432)	18.5(6–48)	0.047^c c for comparing group 2 vs 3
Calcium, mg/dL	9.2±0.6	9.3±0.7	9.4±0.35	0.850
Sodium, mEq/L	138±3.7	137.1±3.9	139.5±2.4	0.123
Potassium, mEq/L	4.23±0.5	4.15±0.7	4.41±0.5	0.121
Fibrinogen, mg/dL	323±95	412±156	336±73	0.010^c c for comparing group 2 vs 3
Procalcitonin, mg/dL	0.61(0.2–14)	0.41(0–121)	0.16(0–0.20)	0.012^b b for comparing group 1 vs 3 ,^c c for comparing group 2 vs 3
Ferritin, mg/dL	139(11–2,736)	157(23–4,167)	170(57–350)	0.370

	Non-standardized Beta ± SE	Adjusted R²2. Cheval S, Adamescu CM, Georgiadis T, Herrnegger M, Piticar A, Legates DR. Observed and potential impacts of the COVID-19 pandemic on the environment. Int J Environ Res Public Health. 2020;17(11):4140. https://doi.org/10.3390/ijerph17114140 https://doi.org/10.3390/ijerph17114140... Model	p-value
Age	0.066±0.15	0.091	<0.001
Gender, male	-0.038±0.68	-0.006	0.654
Hypertension	1.611±0.77	0.024	0.037
Hyperlipidemia	1.627±1.59	0.001	0.294
Smoking	-0.113±0.69	-0.007	0.870
Diabetes Mellitus	0.988±0.90	0.001	0.275
N/L ratio	0.000±0.11	-0.007	0.997
SII	0.001±0.01	-0.047	0.818
Hs-CRP	0.019±0.05	0.086	<0.001
D dimer	0.011±0.02	-0.006	0.624
Fibrinogen	0.009±0.03	0.088	0.001
Procalcitonin	0.008±0.02	-0.008	0.764
Ferritin	0.002±0.01	0.035	0.017
Multivariate
Age	0.059±0.15	0.156	0.002
HsCRP	0.017±0.06	0.156	0.003

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[1] *Corresponding author: ayakyuzq5@gmail.com