Abstract
Background: Since the COVID-19 outbreak, pulmonary involvement was one
of the most significant concerns in assessing patients. In the current
study, we evaluated patient’s clinical and laboratory findings on the
first visit to predict the severity of pulmonary involvement and their
outcome. Methods: Four hundred seventy-eight COVID-19 patients with
positive real-time reverse-transcriptase-polymerase chain reaction
(RT-PCR) or highly suggestive symptoms with computed tomography(CT)
imaging results with typical findings of COVID-19 were enrolled in the
study. The clinical features, initial laboratory, CT findings, and
short-term outcomes (ICU admission, mortality, length of
hospitalization, and recovery time) were recorded. In addition, the
severity of pulmonary involvement was assessed using a semi-quantitative
scoring system (0-25). Results: Among 478 participants in this study,
353 (73.6%) were admitted to the hospital, and 57 (11.9%) patients
were admitted to the ICU. A review of chest CT scans showed that Ground
Glass Opacity (GGO) (58.5%) and consolidation (20.7%) were the most
patterns of lung lesions. Among initial clinical and laboratory
findings, anosmia (P = 0.01), respiratory rate (RR) ≥ 25 (P = 0.001),
C-reactive protein (CRP) ≥ 91 (P = 0.002), white Blood Cell (WBC)
>10,000 (P = 0.009), and SpO2 ≥ 93 (P = 0.04) was
associated with higher chest CT score. Lung involvement and
consolidation lesions on chest CT scans were also associated with more
extended hospitalization and recovery period. Conclusions: Initial
assessment of COVID-19 patients, including symptoms, vital signs, and
routine laboratory tests, can predict the severity of lung involvement
and unfavorable outcomes.