Correlation of CO-RADS Score with Inflammatory Markers in COVID-19 Patients: A Retrospective Analysis at a Designated COVID Centre of Kolhapur, India

Abstract

Introduction: Coronavirus Disease-2019 (COVID-19) Reporting and Data System (CO-RADS) score in Computed Tomography (CT) scan of the chest is a priority investigation in early identification of the disease. Although, a CT scan gives a clear parenchymal picture of the condition, it has its disadvantages of the cost and specificity in the prognosis of COVID-19. In addition, clinical studies have revealed its decreased utility in assessing the severity of the disease. Aim: To understand the correlation of the CO-RADS score with various inflammatory markers and explore the changes in CO- RADS score with the severity of COVID-19 infection. Materials and Methods: The present study is a retrospective observational study in a designated COVID-19 centre in Kolhapur, India. The radiological and pathological records of 64 cases for two months (September to October 2020) were reviewed and charted. The present study included all the cases over 18 years. The authors excluded pregnant women, patients with tuberculosis, interstitial lung disease, and pulmonary malignancy with a view of interference with the radiological presentation of COVID- 19. Along with demographics, biomarkers like Total Leucocyte Count (TLC), C-Reactive Protein (CRP), Lactate Dehydrogenase (LDH), D-Dimer, Interleukin-6 (IL-6), Procalcitonin (PCT), and serum ferritin were retrospectively reviewed and documented. The CO-RADS score, as reported by an expert radiologist, was noted down. Pearson’s correlation coefficient was used to correlate the CO-RADS score with various inflammatory markers. Results: The authors found significant high positive correlation of CT score with LDH (r=0.754; p-value <0.001), moderate positive correlation with IL-6 (r=0.503; p-value <0.001), low positive correlation with CRP (r=0.477; p-value <0.001) and PCT (r=0.461; p-value <0.001). The correlation between the CT score with serum ferritin (r=0.284; p-value=0.023), total leukocyte count (r=0.260; p-value=0.038) and D-dimer (r=0.242; p-value 0.050) was negligible. Conclusion: The CO-RADS CT score is associated with the severity of COVID-19 disease and with mortality. The CO-RADS score showed a high positive correlation with LDH values of the present study. The LDH seems to be a promising marker and has to be further evaluated in assessing early COVID-19 infection with a multi-centric and more extensive sample size approach.