The relationship of radiological criteria predicting severe clinical course, computed tomography (CT) score,clinical indicators and mortality in COVID 19 pneumonia

Some prognostic factors have been developed to predict severe clinical course in COVID-19 pneumonia. It is known that this risk increases in elderly patients (≥ 65 years and over), male gender and patients with cardiovascular comorbidities. Predicting the clinical course of the disease might change patient treatment strategies. The main purpose of this study is; to evaluate the sensitivity and specificity of semi-quantitative CT score, mCHA2DS2-VASc score and R-mCHA2DS2-VASc score that predict the risk of admission to intensive care unit and mortality in COVID 19 pneumonia. In this study, 901 COVID-19 pneumonia cases were evaluated retrospectively. The history and clinical course of the patients were examined, and their mCHA2DS2-VASc scores were calculated. Images were evaluated by two radiologists, one of whom was an experienced thoracic radiologist. Semi-quantitative CT scores were calculated. According to the CT scores; patients with a score between 0-6 are given 0 point; patients with 7-12, 1 point; 13-18, 2 points; and 19-25, 3 points. This radiology component score created was added to the existing mCHA2DS2-VASc scores, and thus R -mCHA2DS2-VASc score obtained. Finally; the relationship between the calculated CT, mCHA2DS2-VASc and R-mCHA2DS2-VASc scores was examined. CT, mCHA2DS2-VASc and R-mCHA2DS2-VASc scores were found to be statistically significant in predicting intensive care admission and mortality. The R-mCHA2DS2-VASc score was superior to other scores in predicting severe clinical course. For this score, the ideal threshold value that can be used to predict mortality is ≥ 8, with a sensitivity of 83.9% and a specificity of 91.6%. As a result; the R-mCHA2DS2-VASc score is successful in predicting the severe clinical course of the disease at an early stage and has high sensitivity and specificity. Unlike other scores, it is a powerful and at the same time practical prognostic scoring system because it includes both clinical and radiological parameters.