Relationship between chest CT pulmonary symptoms, clinical findings and outcomes in patients with RT-PCR confirmed SARS-CoV2 infection and COVID-19 pneumonia upon hospitalisation

COVID-19 pandemic brought additional patient load to emergency departments in many European hospitals. Several studies showed significant clinical heterogeneity in patients with a need of hospitalisation. Thus, World health organisation suggests using diagnostic imaging to enhance decision making. In this study we analyse COVID-19 patients in one of the Latvian university hospital emergency departments. Hospitalised patients with history of RT-PCR confirmed COVID-19 infection before or upon hospitalisation in Riga Eastern University Hospital (REUH), clinical symptoms of acute COVID-19 pneumonia and performed lung CT scan in Emergency department were enrolled in this study for retrospective analysis. Patient’s gender, age, comorbidities, clinical course, complains before hospitalisation, hospital outcomes were compared with initial CT findings. Lung CT scan was performed with the same machine in REAH Gailezers Emergency department. Following symptoms were assessed using originally created protocol: signs of interlobular septal thickening, ground glass opacities, parenchyma bands, infiltrative consolidation, mediastinal and hilar lymphadenopathy, pleural effusion size. Descriptive and analytical statistics was performed by SPSS software. Significance was considered with p<0.05. Study group comprised 71 patient: men 51.5% [Confidence interval: 33.7-63.2%], women 48.5% [36.8-60.3%]. Median age was 64.0 [61.0-68.5]. 36.6% of patients had no comorbidities. Hospital death outcome was in 16.9% [8.5-26.8]. Ground glass opacities were found in all patients: 45.7% had lung damage <10%, 20.0% with damage of 10-25%. There was significant correlation between CT severity of initial lung damage and hospital outcome (p=0.002). No correlation was found between CT severity of initial lung damage and number of comorbidities (0.895) or patient clinical symptoms (cough p=0.391, fever p=0.389, shortness of breath p=0.188). In our study group severe initial lung damage seen on CT was a significant factor of negative outcome. There was no relationship between severity of lung damage and patient clinical symptoms upon hospitalisation.