Figure 1
The flow diagram of patients included in the analysis.
Table 1
COVID-19 Reporting and Data System (CO-RADS) classification.
| CO-RADS 0: Not interpretable Poor image quality or lack of images |
| CO-RADS 1: Very low Normal CT image or non-infectious CT findings. |
| CO-RADS 2: Low Infectious manifestations specific to pathogens other than COVID-19 |
| CORADS-3: Equivocal/unsure Suspicious findings in which can also be caused by other viral pneumonia or non-infectious reasons |
| CO-RADS 4: High COVID-19 findings has typical, but similar with other viral pneumonia |
| CO-RADS 5: Very high Typical COVID-19 pulmonary involvement |
| CORADS-6 Proven rRT-PCR test positive |
Table 2
Demographic characteristics, comorbidities, treatments, outcomes, laboratory, and radiological findings of the participants.
| MEDIAN (IQR) OR N (%) | ||
|---|---|---|
| Age (years) | 55.00 (35.00–68.00) | |
| Lymphocyte (103/μL) | 1.37 (1.01–1.93) | |
| D-dimer (ng/mL) | 394.00 (199.25–1017.50) | |
| C reactive protein (mg/L) | 23.90 (6.00–75.20) | |
| Fibrinogen (mg/dL) | 487.00 (366.00–614.00) | |
| Ferritin (ng/mL) | 166.34 (76.51–403.04) | |
| Lactate dehydrogenase (U/L) | 402.00 (324.00–546.00) | |
| Gender | Male | 563 (62.9) |
| Female | 332 (37.1) | |
| Diabetes Mellitus | 172 (19.2) | |
| Hypertension | 283 (31.6) | |
| Heart Failure | 45 (5.0) | |
| Cardiovascular disease | 106 (11.8) | |
| Chronic kidney disease | 28 (3.1) | |
| Chronic obstructive pulmonary disease | 61 (6.8) | |
| Asthma | 39 (4.4) | |
| Other Pulmonary Disease | 11 (1.2) | |
| Cancer | 37 (4.1) | |
| Stroke | 26 (2.9) | |
| Hydroxycloroquine | 854 (95.4) | |
| Favipravir | 238 (26.6) | |
| Azithromycin | 645 (72.1) | |
| Convalescent plasma | 21 (2.39) | |
| Lopinavir/ritonavir | 63 (7.0) | |
| Tocilizumab | 24 (2.7) | |
| Corticosteroid | 50 (5.6) | |
| SARS CoV-2 PCR | Negative | 434 (48.5) |
| Positive | 461 (51.5) | |
| Chest CT | Negative | 262 (29.3) |
| Positive | 633 (70.7) | |
| CO-RADS | 1 | 188 (21.0) |
| 2 | 74 (8.3) | |
| 3 | 87 (9.7) | |
| 4 | 101 (11.3) | |
| 5 | 445 (49.7) | |
| PCR and CT | PCR:– and CT:– | 112 (12.5) |
| PCR:+ and CT:– | 150 (16.8) | |
| PCR:- and CT:+ | 322 (36.0) | |
| PCR:+ and CT:+ | 311 (34.7) | |
| Mortality | 84 (9.4) | |
| Need for ICU | 135 (15.1) | |
| Need for IMV in ICU | 92 (68.7) | |
[i] IQR: Interquartile Range, PCR: Polymerase Chain Reaction, CT: Computerized Tomography, CO-RADS: COVID-19 Reporting and Data System, ICU: Intensive care unit, IMV: Invasive mechanical ventilation.
Figure 2
RT-PCR –, CO-RADS 5: This 56-year-old male patient had no comorbidity other than coronary artery disease. He presented to the emergency department with a fever of 38.4 degrees. He had no respiratory symptoms. There were no findings compatible with COVID-19 in laboratory parameters. RT-PCR test was negative, multifocal areas of ground glass and consolidation with bilateral pleural effusion were seen on chest CT taken in his emergency admission, and he was diagnosed with COVID-19 and hospitalized. It was evaluated as CO-RADS 5. PCR tests taken on the 1st, 5th, and 11th days of his hospitalization are also negative. The need for intensive care developed on the 11th day of his hospitalization, and he died on the 17th day.
Figure 3
RT-PCR –, CO-RADS 4: This 70-year-old female patient had chronic obstructive pulmonary disease. He presented to the emergency department with a respiratory distress. There are no findings compatible with COVID-19 except d-dimer: 1060 ng/mL CRP: 126 mg/L in laboratory parameters. He was admitted to the intensive care unit with the diagnosis of COVID-19, with negative SARS-CoV-2 PCR test and unilateral ground glass oppacities with emphysema and bronchiectasis on chest CT. It was evaluated as CO-RADS 4. PCR tests on day 1 and day 6 are negative. He died on the 9th day of his hospitalization.
Figure 4
RT-PCR +, CO-RADS 1: This 65-year-old male patient had hypertension, cardiovascular disease, chronic kidney disease, and hyperlipidemia. He presented to the emergency department with shortness of breath and cough. He had hypoxemia. Laboratory parameters compatible with COVID-19 were d-dimer: 990 ng/mL, ferritin: 510 ng/mL, fibrinogen: 443 mg/dL. The patient with positive RT-PCR test and emphysematous changes in both upper lobes of the lungs on CT was hospitalized with the diagnosis of COVID-19. It was evaluated as CO-RADS 1. The patient recovered and was discharged on the 7th day.
Table 3
Comparison of groups formed according to PCR and CT findings.
| PCR– CT– | PCR+ CT– | PCR– CT+ | PCR+ CT+ | Pa | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| N | % | N | % | N | % | N | % | |||
| Discharge Status | Recovery | 104a,b | 92.9 | 145b | 96.7 | 292a,b | 90.7 | 270a | 86.8 | 0.006* |
| Exitus | 8a,b | 7.1 | 5b | 3.3 | 30a,b | 9.3 | 41a | 13.2 | ||
| Need for ICU | No | 99a,c,d | 88.4 | 144c | 96.0 | 274b,d | 85.1 | 243a,b | 78.1 | <0.001** |
| Yes | 13a,c,d | 11.6 | 6c | 4.0 | 48b,d | 14.9 | 68a,b | 21.9 | ||
| Need for IMV ın ICU | No | 3 | 23.1 | 1 | 16.7 | 14 | 29.8 | 24 | 35.3 | 0.669 |
| Yes | 10 | 76.9 | 5 | 83.3 | 33 | 70.2 | 44 | 64.7 | ||
[i] PCR: Polymerase Chain Reaction, CT: Computerized Tomography, ICU: Intensive care unit, IMV: Invasive mechanic ventilation a: Completely different letters next to the frequencies indicate columns that differ significantly.
Pearson’s Chi-Square Test was used, * p < 0.05, ** p < 0.001.
Table 4
Risk factors for mortality.
| B | S.E. | WALD | DF | P | OR | 95% C.I. FOR OR | ||
|---|---|---|---|---|---|---|---|---|
| LOWER | UPPER | |||||||
| CO-RADS | ||||||||
| 3 vs (1+2) | 0.129 | 0.404 | 0.102 | 1 | 0.749 | 1.138 | 0.515 | 2.513 |
| 4 vs (1+2) | 1.185 | 0.392 | 9.127 | 1 | 0.003* | 3.270 | 1.516 | 7.051 |
| 5 vs (1+2) | 0.348 | 0.546 | 0.405 | 1 | 0.525 | 1.416 | 0.485 | 4.128 |
| Lactate dehydrogenase (U/L) | 0.002 | 0.001 | 9.875 | 1 | 0.002* | 1.002 | 1.001 | 1.003 |
| D-dimer (ng/mL) | 0000 | 0.000 | 8.155 | 1 | 0.004* | 1.000 | 1.000 | 1.000 |
| C reactive protein (mg/L) | 0.005 | 0.002 | 5.398 | 1 | 0.020* | 1.005 | 1.001 | 1.010 |
| Fibrinogen (mg/dL) | 0.001 | 0.001 | 0.736 | 1 | 0.391 | 1.001 | .999 | 1.003 |
| Ferritin (ng/mL) | 0.000 | 0.000 | 2.275 | 1 | 0.131 | 1.000 | 1.000 | 1.000 |
| Lymphocyte (103/μL) | -0.109 | 0.171 | 0.408 | 1 | 0.523 | 0.896 | 0.641 | 1.254 |
| Constant | -4.249 | 0.732 | 33.714 | 1 | <0.001** | 0.014 | ||
[i] CO-RADS: COVID-19 Reporting and Data System.
Multivariate logistic regression model was used. * p < 0.05, ** p < 0.001.
Table 5
Risk factors for intensive care unit.
| B | S.E. | WALD | DF | P | OR | 95% C.I. FOR OR | ||
|---|---|---|---|---|---|---|---|---|
| LOWER | UPPER | |||||||
| CO-RADS | ||||||||
| 3 vs (1+2) | –.288 | .339 | .725 | 1 | 0.394 | .749 | .386 | 1.455 |
| 4 vs (1+2) | .714 | .352 | 4.113 | 1 | 0.043* | 2.042 | 1024 | 4.070 |
| 5 vs (1+2) | .187 | .434 | .186 | 1 | 0.666 | 1.206 | .515 | 2.823 |
| Lactate dehydrogenase (U/L) | 0.001 | .001 | 5.172 | 1 | 0.023* | 1.001 | 1.000 | 1.002 |
| D-dimer (ng/mL) | 0.000 | 0.000 | 13.418 | 1 | <0.001** | 1.000 | 1.000 | 1.000 |
| C reactive protein (mg/L) | 0.004 | 0.002 | 4.302 | 1 | 0.038 | 1.004 | 1.000 | 1.009 |
| Fibrinogen (mg/dL) | 0.001 | 0.001 | 0.494 | 1 | 0.482 | 1.001 | 0.999 | 1.002 |
| Ferritin (ng/mL) | 0.000 | 0.000 | 9.903 | 1 | 0.002* | 1.000 | 1.000 | 1.001 |
| Lymphocyte (103/μL) | –0.271 | 0.178 | 2.330 | 1 | 0.127 | 0.763 | 0.538 | 1.080 |
| Constant | –2.911 | 0.618 | 22.162 | 1 | <0.001** | 0.054 | ||
[i] CO-RADS: COVID-19 Reporting and Data System.
Multivariate logistic regression model was used. * p < 0.05, ** p < 0.001.