CT SEVERITY SCORE –A TOOL FOR CLINICAL ASSESSMENT IN COVID 19 PATIENTS ?

Abstract

Background: COVID-19 is an infection that has widely and rapidly spread all over the world. The clinical presentations being asymptomatic carriers to requiring assisted ventilatory support with increased mortality. Clinical parameters like oxygen saturation, respiratory rate and laboratory parameters like CRP, ferritin, d-dimer etc have been used to classify patients according to disease severity. CT chest manifestations in COVID pneumonia resemble to those seen in any viral infection To establish Aims & Objectives: correlation between CT severity score and Clinico-laboratory parameters in RTPCR proven positive COVID 19 patients and study the role of HRCT chest in clinical management of COVID 19 patients. We collected clinical and laboratory data for analysis of pati Materials and Methods: ents who had RTPCR positive COVID-19 infection and underwent a chest HRCT chest scan with 128 slice CT scanner in our tertiary care hospital. Three radiologists evaluated the scan to determine the CT severity score (CTSS) and studied typical, intermediate & atypical imaging features in each patient and assigned CT severity score for oxygen dependency , the patients were classied radiologically into negative, mild and severe disease The statistical analysis was performed using IBM SPSS and Microsoft excel. Descriptive statistics of patients clinical, and laboratory results were reported as numbers and relative frequencies. Frequencies of CT scores were calculated and compared with other clinical variables. The Pearson correlation coefcient test was used for correlations, and p value less than 0.01 was dened statistically signicant. A Chi square analysis was done to establish relationship between CTSS oxygen dependency, remdesivir and steroid usage. CTSS and oxygen dependency had Results: strong negative Pearson's association. Severe CTSS (10 & above) had 98.3% sensitivity in relation to requirement of O2 in patients, with high negative predictive value 99.3%. Positive likelihood ratio 4.33, negative likelihood ratio 0.02. The Pearson's correlation coefcient showed moderately positive signicant association between CTSS & S.CRP levels, CTSS & S.ferritin level. Signicant P value is seen in severe patients having higher CTSS, treated with steroids and remdesivir. A CT-SS score less than 10 could rule out oxygen dependency Conclusion: and severe form of disease with a high negative predictive value of 99.3% in our cohort. Clinical intervention in patients according to CT severity score can be of value as evident by signicant association demonstrated in our study.