The Correlations Between Clinical Characteristics and Inflammation Markers with Chest X-rays in COVID-19 Patients at Ulin Hospital

Authors

  • Muhammad Nor Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Lambung Mangkurat University
  • Ira Nurrasyidah Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Lambung Mangkurat University
  • Mashuri Mashuri Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Lambung Mangkurat University

DOI:

https://doi.org/10.36497/jri.v43i4.407

Keywords:

COVID-19, chest X-ray, disease severity, inflammation markers, PF ratio

Abstract

Background: Chest x-ray is one of the parameters used to estimate the severity and prognosis of COVID-19. Arterial oxygen saturation (SaO2), partial pressure of arterial oxygen (PaO2), and respiratory index (PaO­/FiO2) can also predict the disease severity. Other parameters, like inflammation markers, have also been used as predictors for prognosis. Based on those considerations, this study aimed to examine their connection and find their correlation.

Methods: This was an analytic observational retrospective study. The samples were moderate-critical COVID-19 patients in Ulin General Hospital Banjarmasin from July to December 2021 who met the inclusion and exclusion criteria. Statistical tests were used to see the relationship between clinical characteristics and inflammation markers with chest X-rays using various scoring systems (Brixia, sRALE, and modified Soetomo score).

Results: The total number of subjects was 67. The data analysis found that the severity of the disease had a significant relationship with the severity of the chest x-ray (P<0.001). The PF ratio also had a significant negative correlation (P<0.001) with the severity of the chest x-ray. For inflammation markers, NLR, CRP, and LDH significantly correlated with a chest x-ray. The patient's outcome was also associated with a chest X-ray (P<0.015).

Conclusion: There were significant correlations between clinical characteristics and inflammation markers on the chest X-ray severity, and sRALE was a better scoring system to assess chest X-ray severity than other scoring systems.

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References

Oliynyk O V., Rorat M, Barg W. Oxygen metabolism markers as predictors of mortality in severe COVID-19. Int J Infect Dis. 2021;103:452–6.

Martínez Chamorro E, Díez Tascón A, Ibáñez Sanz L, Ossaba Vélez S, Borruel Nacenta S. Diagnóstico radiológico del paciente con COVID-19. Radiologia. 2021;63(1):56–73.

Haryati, Isa M, Assagaf A, Nurrasyidah I, Kusumawardhani E, Su-Hartono E, et al. Clinical and laboratory features of COVID-19 in Ulin Referral Hospital of South Kalimantan: Predictors of clinical outcome. J Trop Life Sci. 2021;11(3):299–307.

Mukherjee S, Pahan K. Is COVID-19 gender-sensitive? Journal of Neuroimmune Pharmacology. 2021;16(1):38–47.

Abate BB, Kassie AM, Kassaw MW, Aragie TG, Masresha SA. Sex difference in coronavirus disease (COVID-19): A systematic review and meta-analysis. BMJ Open. 2020;10(10):e040129.

Karyono DR, Wicaksana AL. Current prevalence, characteristics, and comorbidities of patients with COVID-19 in Indonesia. Journal of Community Empowerment for Health. 2020;3(2):77–84.

Dyer O. Covid-19: Indonesia becomes Asia’s new pandemic epicentre as delta variant spreads. BMJ. 2021;374:n1815.

Chookajorn T, Kochakarn T, Wilasang C, Kotanan N, Modchang C. Southeast Asia is an emerging hotspot for COVID-19. Nature Medicine 2021 27:9. 2021;27(9):1495–6.

Florensa D, Mateo J, Spaimoc R, Miret C, Godoy S, Solsona F, et al. Severity of COVID-19 cases in the months of predominance of the Alpha and Delta variants. Sci Rep. 2022;12(1):15456.

Swarjana IK, Suyasa IGPD, Nuryanto IK. Predictors of anxiety toward COVID-19 Delta variant: A cross- sectional study among healthcare providers in Java and Bali, Indonesia. Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal). 2022;17(3):204–11.

Singh AK, Gillies CL, Singh R, Singh A, Chudasama Y, Coles B, et al. Prevalence of co-morbidities and their association with mortality in patients with COVID-19: A systematic review and meta-analysis. Diabetes Obes Metab. 2020;22(10):1915–24.

Haryati H, Isa M, Assagaf A, Nurrasyidah I, Kusumawardhani E. Clinical characteristics of hospitalized individuals dying with COVID-19 in Ulin Regional Hospital Banjarmasin. Jurnal Respirasi. 2021;7(1):1–7.

Tang X, Du RH, Wang R, Cao TZ, Guan LL, Yang CQ, et al. Comparison of hospitalized patients with ARDS caused by COVID-19 and H1N1. Chest. 2020;158(1):195–205.

Putra NPP, Listyoko AS, Christanto A. PaO2, SaO2, dan Rasio PaO2/FiO2 sebagai prediktor derajat keparahan pasien COVID-19 rawat inap. Journal of The Indonesian Medical Association. 2020;70(12):253–9.

Setiawati R, Widyoningroem A, Handarini T, Hayati F, Basja AT, Surya ARD, et al. Modified chest X-ray scoring system in evaluating severity of COVID-19 patient in Dr. Soetomo General Hospital Surabaya, Indonesia. Int J Gen Med. 2021;14:2407–12.

Duc VT, Thuy TTM, Nam NH, Tram HTB, Thao TTP, Doan LT, et al. Correlation of chest x-ray scores in SARS-CoV-2 patients with the clinical severity classification and the quick COVID-19 severity index. Cureus. 2022;14(5):e24864.

Toussie D, Voutsinas N, Finkelstein M, Cedillo MA, Manna S, Maron SZ, et al. Clinical and chest radiography features determine patient outcomes in young and middle-aged adults with COVID-19. Radiology. 2020;297(1):E197–206.

Chen H, Ai L, Lu H, Li H. Clinical and imaging features of COVID-19. Radiol Infect Dis. 2020;7(2):43–50.

Baratella E, Crivelli P, Marrocchio C, Bozzato AM, De Vito A, Madeddu G, et al. Severity of lung involvement on chest X-rays in SARS-coronavirus-2 infected patients as a possible tool to predict clinical progression: An observational retrospective analysis of the relationship between radiological, clinical, and laboratory data. J Bras Pneumol. 2020;46(5):e20200226.

Velissaris D, Lagadinou M, Paraskevas T, Oikonomou E, Karamouzos V, Sampsonas F, et al. Evaluation of admission chest x-ray findings in patients with respiratory infection during the COVID-19 pandemic. Cureus. 2021;13(9):e18114.

Basille D, Auquier MA, Andréjak C, Rodenstein DO, Mahjoub Y, Jounieaux V. Dissociation between the clinical course and chest imaging in severe COVID-19 pneumonia: A series of five cases. Heart Lung. 2021;50(6):818–24.

Kumar H, Fernandez CJ, Kolpattil S, Munavvar M, Pappachan JM. Discrepancies in the clinical and radiological profiles of COVID-19: A case-based discussion and review of literature. World J Radiol. 2021;13(4):75–93.

Sensusiati AD, Amin M, Nasronudin N, Rosyid AN, Ramadhan NA, Lathifah R, et al. Age, neutrophil lymphocyte ratio, and radiographic assessment of the quantity of lung edema (RALE) score to predict in-hospital mortality in COVID-19 patients: A retrospective study. F1000Res. 2021;9:1286.

Wagner J, DuPont A, Larson S, Cash B, Farooq A. Absolute lymphocyte count is a prognostic marker in COVID-19: A retrospective cohort review. Int J Lab Hematol. 2020;42(6):761–5.

Fachri M, Hatta M, Widowati E, Akaputra R, Dwiyanti R, Syukri A, et al. Correlations between comorbidities, chest x-ray findings, and c-reactive protein level in patients with COVID-19. Ann Med Surg (Lond). 2022;77:103553.

Geetika P, Varunya M, Suresh A, Sudhanva N, Swathi M, Kaviya V. Correlation of chest x-rays with lab parameters in COVID-19. European Journal of Molecular & Clinical Medicine. 2022;9(4):1911–20.

Wallis TJM, Heiden E, Horno J, Welham B, Burke H, Freeman A, et al. Risk factors for persistent abnormality on chest radiographs at 12-weeks post hospitalisation with PCR confirmed COVID-19. Respir Res. 2021;22(1):1–9.

Huang Y, Guo L, Chen J, Wu M, Zhang C, Liu Z, et al. Serum lactate dehydrogenase level as a prognostic factor for COVID-19: A retrospective study based on a large sample size. Front Med (Lausanne). 2022;8:671667.

Ali N. Elevated level of c-reactive protein may be an early marker to predict risk for severity of COVID-19. J Med Virol. 2020;92(11):2409–11.

Zhang Y, Wu W, Du M, Luo W, Hou W, Shi Y, et al. Neutrophil-to-lymphocyte ratio may replace chest computed tomography to reflect the degree of lung injury in patients with corona virus disease 2019 (COVID-19). Res Sq. 2020;

Garg PK, Khera PS, Saxena S, Sureka B, Garg MK, Nag VL, et al. Chest-x-ray-based scoring, total leukocyte count, and neutrophil-to-lymphocyte ratio for prediction of COVID-19 in patients with severe acute respiratory illness. Turk Thorac J. 2021;22(2):130–6.

Kotok D, Rivera J, Girard C, Kim AI, Shettigar S, Lavina A, et al. Neutrophil-to-lymphocyte ratio in associated with severity of radiographic edema on chest x-ray in patients with COVID-19. American Thoracic Society International Conference Meetings Abstracts American Thoracic Society International Conference Meetings Abstracts. 2022;205:A3164–A3164.

Yang L, Liu S, Liu J, Zhang Z, Wan X, Huang B, et al. COVID-19: Immunopathogenesis and immunotherapeutics. Signal Transduction and Targeted Therapy 2020 5:1. 2020;5(1):1–8.

Borghesi A, Zigliani A, Golemi S, Carapella N, Maculotti P, Farina D, et al. Chest x-ray severity index as a predictor of in-hospital mortality in coronavirus disease 2019: A study of 302 patients from Italy. International Journal of Infectious Diseases. 2020;96:291–3.

Balbi M, Caroli A, Corsi A, Milanese G, Surace A, Di Marco F, et al. Chest x-ray for predicting mortality and the need for ventilatory support in COVID-19 patients presenting to the emergency department. Eur Radiol. 2021;31(4):1999–2012.

Yasin R, Gouda W. Chest x-ray findings monitoring COVID-19 disease course and severity. The Egyptian Journal of Radiology and Nuclear Medicine. 2020;51(1):193.

Kodikara I, Galabada BA, Hettiarachchi S. The mortality predicting ability of chest x-ray severity scoring systems in Covid-19 pneumonia. Ceylon Med J. 2021;66(4):168–76.

Kotok D, Girard C, Rivera Robles J, Kim A, Shettigar S, Lavina A, et al. Emergency department chest x-ray severity in patients with COVID-19 is associated with hypoxemia and clinical outcomes. Am J Respir Crit Care Med. 2021;203(9):A2486–A2486.

Cecchini S, Di Rosa M, Soraci L, Fumagalli A, Misuraca C, Colombo D, et al. Chest x-ray score and frailty as predictors of in-hospital mortality in older adults with COVID-19. J Clin Med. 2021;10(13):2965.

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Published

2023-10-31

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