Turkiye Klinikleri Archives of Lung

.: ORIGINAL RESEARCH
The Impact of Morphological Shapes in Chest Computed Tomography on Disease Severity in COVID-19 Pneumonia: A Descriptive Study
COVID-19 Pnömonisinde Toraks Bilgisayarlı Tomografideki Morfolojik Şekillerin Hastalık Şiddeti Üzerindeki Etkisi: Tanımlayıcı Bir Çalışma
Bilge Sezin AKHANa , Nigar YILMAZb
aGemlik State Hospital, Clinic of Radiology, Bursa, Türkiye
bGemlik State Hospital, Clinic of Biochemistry, Bursa, Türkiye
Turkiye Klinikleri Arch Lung. 2023;22(3):49-57
doi: 10.5336/archlung.2023-99821
Article Language: EN
Full Text
ABSTRACT
 Objective: This study aimed to evaluate the relationship between the shapes of lung lesions on computed tomography (CT) scans of patients with coronavirus disease-2019 (COVID-19) pneumonia and course of the disease based on laboratory data. Material and Methods: A total of 500 patients with COVID-19 pneumonia were included in the study, and were divided into four groups based on the shapes of the lung lesions in their CT scans: Group A (round-shaped), Group B (patchy-shaped), Group C (halo sign/reverse halo), and Group D (diffuse). Laboratory data, including lymphocyte, C-reactive protein, lactate dehydrogenase, ferritin and D-dimer tests, were collected for all patients, and the 4 groups were compared with the laboratory results to evaluate their association with disease severity. Results: The results showed that patchy-shaped lesions were the most common (44.6%), whereas halo sign/reverse halo sign were rare, with only 15 patients (3%) in Group C. Patients with round lesions were found to have milder disease severity, with stable laboratory results. Conversely, patients in Group B with patchy shape exhibited less favorable disease severity compared to Group A. Those with halo/reversed halo signs had minimal lung involvement but higher inflammatory markers. Patients with diffuse spread showed the highest disease severity and poorest laboratory findings. Conclusion: Describing and evaluating lung lesion shapes on CT scans of COVID-19 pneumonia patients can guide clinicians in managing the disease and hospitalization decisions. Our findings suggest that in predicting the course of COVID-19 pneumonia, the shapes of lung lesions on CT scans may be a more critical determinant than their extent.

Keywords: COVID-19; viral pneumonia; multislice computed tomography; disease severity; biomarkers
ÖZET
 Amaç: Bu çalışma, koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID-19)] pnömonili hastaların toraks bilgisayarlı tomografi (BT) taramalarındaki akciğer lezyonlarının morfolojik şekilleri ile laboratuvar verilerine dayalı hastalığın seyrini değerlendirmeyi amaçlamıştır. Gereç ve Yöntemler: Toplam 500 COVID-19 pnömonili hasta çalışmaya dâhil edildi ve toraks BT taramalarındaki akciğer lezyonlarının şekline göre 4 gruba ayrıldı: A grubu (yuvarlak şekilli), B grubu (yamasal şekilli), C grubu (halo/ters halo işareti), ve D grubu (diffüz yayılma). Tüm hastaların lenfosit sayıları, C-reaktif protein, laktat dehidrogenaz, ferritin ve D-dimer testleri dâhil olmak üzere laboratuvar verileri toplandı ve 4 grup, hastalık şiddeti üzerine etkisi değerlendirilmek amacıyla laboratuvar test sonuçları ile karşılaştırıldı. Bulgular: Sonuçlar, yamasal şekilli lezyonların en yaygın olduğunu (%44,6), halo /ters halo işaretli lezyonların ise nadir olduğunu, sadece C grubunda 15 hastada (%3) bulunduğunu gösterdi. Yuvarlak lezyonlara sahip hastaların (A Grubu), daha hafif hastalık şiddetine ve stabil laboratuvar sonuçlarına sahip olduğu bulundu. Buna karşılık, yamalı şekilli olan B grubundaki hastalar, A grubuna göre daha az olumlu hastalık şiddeti göstermiştir. Halo veya ters halo işareti olanlar minimal akciğer tutulumuna sahipti ancak daha yüksek inflamatuar belirteçlere sahipti. Lezyonların yayılma gösterdiği D grubundaki hastalar en yüksek hastalık şiddeti ve en kötü laboratuvar bulgularına sahipti. Sonuç: COVID-19 pnömonisi olan hastalar hastaneye başvurduğunda alınan toraks BT taramalarında gözlenen akciğer lezyonlarının morfolojik şekillerini tanımlamak ve bunların hastalık şiddeti üzerindeki etkisini değerlendirmek, klinisyenlere hastalığın yönetimi ve hastaneye yatış kararlarında değerli bir rehberlik sağlayabilir. Bulgularımız, COVID-19 pnömonisinin seyrini tahmin etmede, toraks BT taramalarındaki akciğer lezyonlarının şekillerinin, yayılım ve dağılımlarından daha kritik bir belirleyici olabileceğini önermektedir.

Anahtar Kelimeler: COVID 19; viral pnömoni; çok kesitli bilgisayarlı tomografi; hastalık şiddeti; biyobelirteçler
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