1. Generalized chest CT and lab curves throughout the course of COVID-19
- Author
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Anna Maria Ierardi, Gianpaolo Carrafiello, Sameer S Kadri, Maurizio Cariati, Bradford J. Wood, Stephanie Harmon, Baris Turkbey, Daguang Xu, Evrim B. Turkbey, Kaiyun Sun, Francesca Patella, Peng An, Alice Scarabelli, Sheng Xu, Maxime Blain, Dong Yang, Mona Flores, Michael T. Kassin, Ziyue Xu, Holger R. Roth, Nicole Varble, Amel Amalou, and Elvira Stellato
- Subjects
Adult ,Male ,medicine.medical_specialty ,Science ,Clinical Chemistry Tests ,Severity of Illness Index ,Procalcitonin ,Ground-glass opacity ,Article ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Severity of illness ,Machine learning ,medicine ,Medical imaging ,Humans ,Computed tomography ,Retrospective Studies ,Multidisciplinary ,Lung ,Hematologic Tests ,business.industry ,SARS-CoV-2 ,Laboratory techniques and procedures ,COVID-19 ,Retrospective cohort study ,Middle Aged ,Thorax ,medicine.disease ,Clinical trial ,Pneumonia ,medicine.anatomical_structure ,Outcomes research ,030220 oncology & carcinogenesis ,Three-dimensional imaging ,Medicine ,Female ,Radiology ,medicine.symptom ,business ,Tomography, X-Ray Computed - Abstract
A better understanding of temporal relationships between chest CT and labs may provide a reference for disease severity over the disease course. Generalized curves of lung opacity volume and density over time can be used as standardized references from well before symptoms develop to over a month after recovery, when residual lung opacities remain. 739 patients with COVID-19 underwent CT and RT-PCR in an outbreak setting between January 21st and April 12th, 2020. 29 of 739 patients had serial exams (121 CTs and 279 laboratory measurements) over 50 ± 16 days, with an average of 4.2 sequential CTs each. Sequential volumes of total lung, overall opacity and opacity subtypes (ground glass opacity [GGO] and consolidation) were extracted using deep learning and manual segmentation. Generalized temporal curves of CT and laboratory measurements were correlated. Lung opacities appeared 3.4 ± 2.2 days prior to symptom onset. Opacity peaked 1 day after symptom onset. GGO onset was earlier and resolved later than consolidation. Lactate dehydrogenase, and C-reactive protein peaked earlier than procalcitonin and leukopenia. The temporal relationships of quantitative CT features and clinical labs have distinctive patterns and peaks in relation to symptom onset, which may inform early clinical course in patients with mild COVID-19 pneumonia, or may shed light upon chronic lung effects or mechanisms of medical countermeasures in clinical trials.
- Published
- 2021