Correlation of computerized tomography findings of novel corona virus disease with the duration of clinical presentation

Authors

  • Sara Mahmood Ahmed Department of Surgery/ Radiology, College of Medicine, Hawler Medical University, Erbil, Iraq.
  • Aras Rafiq Abdullah Department of Surgery/ Radiology, College of Medicine, Hawler Medical University, Erbil, Iraq.

DOI:

https://doi.org/10.15218/zjms.2025.004

Keywords:

Computerized tomography, COVID-19, Correlation, RT-PCR, CO-RADS

Abstract

Background and objective: Physicians were more interested in using CT imaging techniques because of the limitations of RT-PCR during the COVID-19 pandemic and CT proved high specificity but moderate sensitivity in the diagnosis of the disease. The aim of the study was to find the correlation of the CT scan findings of the novel coronavirus disease with the duration of clinical presentation.

Methods: A cross-sectional study conducted in governmental and non-governmental tertiary hospitals in Erbil city that receive COVID-19 patients. The study started from May 2021 till June 2022. A convenience sampling method was used and 100 COVID -19 patients were included in the study. The Dutch Radiological Society CO-RADS assessment scheme was used to find the degree of suspicion for pulmonary involvement of COVID-19. The semi quantitative CT severity score was used to assess the degree of parenchymal involvement per lobe. A score less than 8 is considered mild, between 8-15 means moderate, and more than 15 is considered severe lung involvement.

Results: Significant differences were found between age groups and stages of disease (P = 0.028). The highest rate of severe cases was in two age groups (40-59 and 60-79 years); 50% and 40% respectively. The bilateral ground-glass appearance was the predominant feature in all three degrees of the disease, 76%, 60%, and 52% respectively. The Spearman's Correlation Coefficient (r) was calculated, and a positive correlation was found between the age and CT- scores (r =0.188, P = 0.061). A positive correlation was noticed between the time of first symptoms appeared and CT scores with a significant P-value (r = 0.382, P <0.001).

Conclusion: A positive correlation was detected between CT scoring and the duration of the clinical presentation. The CT scoring methods used in the current study were beneficial and applicable in predicting COVID-19 pneumonia.

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References

Zhou S, Wang Y, Zhu T, Xia L. CT features of coronavirus disease 2019 (COVID-19) pneumonia in 62 patients in Wuhan, China. AJR. 2020; 215(6):1287-94. Available from: https://www.arrs.org/uploadedfiles/ARRS/education/covid19/COVID19-CT-PNEUMONIA.pdf

World Health Organization. Disease outbreaks by year. Available from: https://www.who.int/csr/don/archive/year/en/.

de Wit E, van Doremalen N, Falzarano D, Munster VJ. SARS and MERS: recent insights into emerging coronaviruses. Nat Rev Microbiol. 2016; 14(8):523-34. Available from: https://pubmed.ncbi.nlm.nih.gov/27344959/.

World Health Organization. Solidarity clinical trial forCOVID-19 treatments. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus

Fang Y, Zhang H, Xie J, Lin M, Ying L, Pang P, et al. Sensitivity of Chest CT for COVID-19: Comparison to RT-PCR. Radiology. 2020; 296(2). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7233365/

Malguria N, Yen LH, Lin T, Hussein A, Fishman EK. Role of Chest CT in COVID-19. J Clin Imaging Sci. 2021; 3(11):30. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8247924/.

Rubin GD, Ryerson CJ, Haramati LB, Sverzellati N, Kanne JP, Raoof S, et al. The role of chest imaging in patient management during the COVID-19 pandemic: A multinational consensus statement from the Fleischner society. Chest. 2020; 158:106–16. Available from: https://pubmed.ncbi.nlm.nih.gov/32155105/

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020; 323:1061–9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7042881/

Bai HX, Hsieh B, Xiong Z, Halsey K, Choi JW, Tran TML et al. Performance of Radiologists in Differentiating COVID-19 from Non-COVID-19 Viral Pneumonia at Chest CT. Radiology. 2020; 296(2):E46-54. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7233414/.

Sharif PM, Nematizadeh M, Saghazadeh M, Saghazadeh A, Rezaei N. Computed tomography scan in COVID-19: a systematic review and meta-analysis. Pol J Radiol. 2022; 87:e1-23. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8814899/

Simpson S, Kay FU, Abbara S, Bhalla S, Chung JH, Chung M, et al. Radiological Society of North America Expert Consensus Statement on Reporting Chest CT Findings Related to COVID-19. Endorsed by the Society of Thoracic Radiology, the American College of Radiology, and RSNA - Secondary Publication. J Thorac Imaging. 2020; 35(4):2. Available from: https://pubmed.ncbi.nlm.nih.gov/32324653/ .

Lessmann N, Sánchez CI, Beenen L, Boulogne LH, Brink M, Calli E, et al. Automated Assessment of COVID-19 Reporting and Data System and Chest CT Severity Scores in Patients Suspected of Having COVID-19 Using Artificial Intelligence. Radiology. 2021; 298(1):E18-28. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7393955/ .

Hansell DM, Bankier AA, MacMahon H, McLoud TC, Müller NL, Remy J. Fleischner society: glossary of terms for thoracic imaging. Radiology. 2008; 246:697–722. Available from: https://pubmed.ncbi.nlm.nih.gov/18195376/

Francone M, Iafrate F, Masci GM, Coco S, Cilia F, Manganaro L, et al. Chest CT score in COVID-19 patients:correlation with disease severity and short-term prognosis. European Radiol. 2020; 30(12):6808-17. Available from: https://pubmed.ncbi.nlm.nih.gov/32623505.

Jakhmola S, Baral B, Jha HC. A comparative analysis of COVID-19 outbreaks on age groups and both the sexes of population from India and other countries. J Infect Dev Ctries 2021; 31; 15(3):333-41.

Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al . Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020; 382: 1–13. Available from: https://search.bvsalud.org/global-literature-on-novel-coronavirus-2019-ncov/resource/en/covidwho-1428982.

Grant MC, Geoghegan L, Arbyn M, Mohammed Z, McGuinness L, Clarke EL, et al. The prevalence of symptoms in 24,410 adults infected by the novel coronavirus (SARS-CoV-2; COVID-19): A systematic review and meta-analysis of 148 studies from 9 countries. PLoSOne. 2020; 15(6):e0234765. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7310678/

Chung M, Bernheim A, Mei X, Zhang N, Huang M, Zeng X, et al. CT imaging features of 2019 novel coronavirus (2019-nCoV). Radiology 2020; 295(1):202-7. Available from: https://pubs.rsna.org/doi/full/10.1148/radiol.2020200230.

Xie Y, Yang L, Dong H, Cao S, Zhang W, Chen Q,et al. Correlation between clinical course and radiographic development on CT scan in patients with COVID-19. Journal of Intensive Medicine. 2021; 1(1):52-8. Available from: https://www.sciencedirect.com/science/article/pii/S2667100X2100013X.

de Smet K, de Smet D, Ryckaert T, Laridon E, Heremans B, Vandenbulcke R, et al. Diagnostic performance of chest CT for SARS-CoV-2 infection in individuals with or without COVID-19 symptoms. Radiology. 2020; 298:E30-7. Available from: https://pubmed.ncbi.nlm.nih.gov/32776832/

Hafez MAF. The mean severity score and its correlation with common computed tomography chest manifestations in Egyptian patients with COVID-2019 pneumonia. Egypt J Radiol Nucl Med. 2020; 51(1):254. Available from: https://ejrnm.springeropen.com/articles/10.1186/s43055-020-00368-y#citeas

CDC fact sheet. About 2019 Novel Coronavirus (2019-nCoV). Centers for Disease Control and Prevention. 2020. Available from: https://www.cdc.gov/Coronavirus/2019-ncov/about/symptoms.html.

Bellos I, Tavernaraki K, Stefanidis K, Michalopoulou O, Lourida G, Korompoki E, et al. Chest CT severity score and radiological patterns as predictors of disease severity, ICU admission, and viral positivity in COVID-19 patients. Respir Investig. 2021; 59(4):436-45. Available from: https://ejrnm.springeropen.com/articles/10.1186/s43055-020-00368-y#citeas

San-Juan R, Barbero P, Fernandez-Ruiz M, Lopez-Medrano F, et al. Incidence and clinical profiles of COVID-19 pneumonia in pregnant women: A single-center cohort study from Spain. E Clinical Medicine. 2020; 23. Available from: https://pubmed.ncbi.nlm.nih.gov/32632417/

Wong HYF, Lam HYS, Fong AHT, Leung ST, Chin T W-Y, Lo CSY, et al. Frequency and Distribution of Chest Radiographic Findings in COVID-19 Positive Patients. Radiology. 2020. Available from: https://pubmed.ncbi.nlm.nih.gov/32216717/

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Published

2025-04-23

How to Cite

Mahmood Ahmed, S., & Rafiq Abdullah, A. . (2025). Correlation of computerized tomography findings of novel corona virus disease with the duration of clinical presentation . Zanco Journal of Medical Sciences (Zanco J Med Sci), 29(1), 30–40. https://doi.org/10.15218/zjms.2025.004

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Original Articles