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. 2024 Apr;12(4):e1239.
doi: 10.1002/iid3.1239.

Correlation of clinical, laboratory, and short-term outcomes of immunocompromised and immunocompetent COVID-19 patients with semi-quantitative chest CT score findings: A case-control study

Abdolkarim Haji Ghadery  1 , Ladan Abbasian  2 , Fatemeh Jafari  2 , Niloofar Ayoobi Yazdi  3 , Zahra Ahmadinejad  4
Affiliations

Correlation of clinical, laboratory, and short-term outcomes of immunocompromised and immunocompetent COVID-19 patients with semi-quantitative chest CT score findings: A case-control study

Abdolkarim Haji Ghadery et al. Immun Inflamm Dis. 2024 Apr.

Abstract

Background: As the effects of immunosuppression are not still clear on COVID-19 patients, we conducted this study to identify clinical and laboratory findings associated with pulmonary involvement in both immunocompromised and immunocompetent patients.

Methods: A case-control of 107 immunocompromised and 107 immunocompetent COVID-19 patients matched for age and sex with either positive RT-PCR or clinical-radiological findings suggestive of COVID-19 enrolled in the study. Their initial clinical features, laboratory findings, chest CT scans, and short-term outcomes (hospitalization time and intensive care unit [ICU] admission) were recorded. In addition, pulmonary involvement was assessed with the semi-quantitative scoring system (0-25).

Results: Pulmonary involvement was significantly lower in immunocompromised patients in contrast to immunocompetent patients, especially in RLL (p = 0.001), LUL (p = 0.023), and both central and peripheral (p = 0.002), and peribronchovascular (p = 0.004) sites of lungs. Patchy (p < 0.001), wedged (p = 0.002), confluent (p = 0.002) lesions, and ground glass with consolidation pattern (p < 0.001) were significantly higher among immunocompetent patients. Initial signs and symptoms of immunocompromised patients including dyspnea (p = 0.008) and hemoptysis (p = 0.036), respiratory rate of over 25 (p < 0.001), and spo2 of below 93% (p = 0.01) were associated with higher pulmonary involvement. Total chest CT score was also associated with longer hospitalization (p = 0.016) and ICU admission (p = 0.04) among immunocompromised patients.

Conclusions: Pulmonary involvement score was not significantly different among immunocompromised and immunocompetent patients. Initial clinical findings (dyspnea, hemoptysis, higher RR, and lower Spo2) of immunocompromised patients could better predict pulmonary involvement than laboratory findings.

Keywords: COVID‐19; case‐control; chest CT score; immunocompetent; immunocompromised.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Chest CT Scan of an immunocompromised patient with diffuse involvement of the lung. These pictures, show 34‐year‐old immunocompromised female patient with diffuse involvement of all five lobes of her lung, this pattern was significantly higher among immunocompromised patients. All 5 lobes of this patient's lung (Shown in A and B) scored 5/5 based on the semiquantitative scoring system with a sum of 25/25 showing the severity of lung involvement in this patient.
Figure 2
Figure 2
Chest CT scan of an immunocompetent patient with ground glass and consolidation pattern of lesions. These Pictures, depict a 54‐year‐old immunocompetent male patient with involvement of Right lower and left lower lobes, with central, peripheral, and anteroposterior locations of lesions, and both wedged and confluent shapes of lesions and mixed patterns of ground glass and consolidation which were significantly higher among immunocompetent patients. The right lower lobe scored 4/5 and the left lower lobe scored 3/5 (Shown in A and B) based on the semiquantitative scoring system and with 1/5 for the other three lobes with the sum of 10/25.
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