Analysis of the Interrelation between Clinical, Laboratory and Radiological Characteristics of Patients with COVID-19 Depending on the Outcome
Authors:   Ryazan State Medical University, Uryas’yev Oleg M. , Solov’yeva Aleksandra V. ,   Ryazan State Medical University, Smaznova Ol’ga A. ,   Emergency Medical Care Hospital, Glotov Sergey I. ,   Ryazan State Medical University, Shurpo Ekaterina M. ,   Ryazan State Medical University,   Emergency Medical Care Hospital
Published: January 2025

INTRODUCTION: The clinical picture of COVID-19 has been highly variable since the onset of the pandemic: most patients present with mild symptoms, while others develop severe respiratory failure. It seems relevant to compare subjective and objective manifestations of COVID-19 in hospitalized patients and to evaluate the prognostic significance of clinical, laboratory and radiological characteristics of COVID-19.
AIM: To analyze the interrelation between the evidence of subjective and objective data, comorbidity in patients with COVID-19 depending on the outcome of the disease.
MATERIALS AND METHODS: The study included 96 patients aged from 25 to 95 years, hospitalized in COVID hospital of City Clinical Emergency Care Hospital of Ryazan from February to May 2022. Patients underwent evaluation of cough and dyspnea intensity on Borg scale, physical examination, laboratory examination, X-ray computed tomography (X-ray CT) of lungs or roentgenography. Depending of the clinical outcome, patients were divided into 2 groups: a group of survivors (68 patients) and a group of deceased (28 patients). Statistical analysis of the data was performed using Statistica 10.0 software package (Stat Soft Inc., USA).
RESULTS: The most common complaints on admission were shortness of breath (75%) and general weakness (96.8%). Twenty-four patients indicated absence of dyspnea, while in 19 of them, saturation below 95.0% was recorded. In patients with ‘silent’ dyspnea, X-ray CT revealed statistically significant strong reverse correlation relationships between saturation and lung lesion volume (р < 0.05). Deceased patients had higher subjective evidence of dyspnea and frequency of distant wheezes (р = 0.002 and р < 0.0001, respectively). Overweight, postinfarction cardiosclerosis, chronic heart failure, type 2 diabetes mellitus were more common among deceased patients. Saturation on admission was statistically significantly lower in the group of deceased (р < 0.0001). The first degree of lung damage on X-ray CT was more common in the group of survivors (0.009), the fourth degree of lung damage more commonly occurred in the group of deceased (р = 0.01). In the group of deceased, the hemoglobin level was significantly lower (р = 0,044), and the levels of fibrinogen, lactate dehydrogenase (LDH), urea, glucose, were significantly higher than in the group of survivors.
CONCLUSION: When evaluating the severity of the disease in patients with COVID-19, it is necessary to take into account not only the level of laboratory markers, such as LDH, fibrinogen, urea, fasting glycemia, laboratory instrumental test results that evaluate the severity of respiratory failure and spread of the lung tissue damage, but also subjective manifestations of the disease such as higher intensity of dyspnea and distant wheezes. Patients who have reduced saturation with no complaints of dyspnea require increased attention.