A Comprehensive Study on Prediction Reliability of The Severity of Computed Tomography Involvement in Patients with Covid-19

Purpose: Computed tomography (CT) emerges as a high–sensitivity tool in diagnosing SARS-CoV-2 virus on admission, even with the cases of negative reverse transcription polymerase chain reaction (RT-PCR). Moreover, CT plays a significant role in the evaluation of disease severity. In this study, we aimed to identify several parameters that could aid in evaluating the initial chest CT severity score (CT-SS).Methods: A total of 348 RT-PCR positive patients were divided into three groups by evaluating the chest CT severity score (CT-SS) in detail. These three groups were defined as the CT-SS obtained 0-7, 8-15, 16-40 classified as mild, moderate and severe involvement, respectively. Patients with end-stage malignancy or immunodeficiency were excluded from the study. All CT images were evaluated by two chest radiologists, unaware of the clinical data.Results: The analysis of categorical variables show that the chest CT-SS tends to increase with higher CHA2DS2VASC risk score (RS) (p= 0.001), M-CHA2DS2VASC RS (p = 0.001), and CHADS2 RS (p = 0.003). Moreover, age, hypertension, cardiothoracic ratio, aortic diameter, white blood cell count, neutrophil counts, neutrophil-lymphocyte ratio, c-reactive protein, D-dimer, ferritin, fibrinogen, blood urea nitrogen, and lactate dehydrogenase were also found to be associated with higher chest CT-SS. A 5-variable multivariable linear regression model, consisting of more frequently used variables, suggests a higher CHA2DS2VASC RS as the only statistically significant variable predicting a higher severity scoreConclusion: The CHA2DS2VASC RS may assist clinicians in predicting the CT-SS in COVID-19 patients, even if they are asymptomatic.