Correlation of CT scan Chest Severity Score with Serum Ferritin in COVID-19 Disease: A Retrospective Study

Abstract

Background: COVID-19 disease is due to SARS-CoV-2 Virus with its rapid progression causing severe and fatal complications like Pneumonia.  CT scan chest and inflammatory biomarkers like serum ferritin, helpful in screening, clinical management and prevention of serious complications of the Covid-19 disease are to be investigated and assessed. Aims and Objectives: This study is aimed to assess the association between the CT Scan Chest severity score and the Serum Ferritin levels in COVID -19 disease in predicting clinical severity with categorization into different risk groups to identify patients at risk of fatal complications to ensure optimal resource allocation. Materials and Methods: This retrospective observational study in a Govt. Medical college attached Tertiary care hospital for COVID –19 disease in Andhra Pradesh from 1st to 31st October 2020 included 76 patients of Covid-19 disease of > 20 years of age admitted with laboratory confirmed RT PCR diagnosis of Covid – 19 disease. Data was collected from the hospital records of the patients on demography, radiological imaging of CT scan chest severity score and laboratory measurements of Serum Ferritin levels and tabulated with the results expressed as mean ± SD.  The disease severity was classified as mild (1-8), moderate (9-15) and severe (16-25)  based on CT scan chest Severity scoring. Then the association between CT scan chest severity score and serum ferritin levels was studied, assessed and  correlated. Results: Study data of a total of 76 COVID –19 positive patients was analysed and summarized. 54 patients (71%) were Males and 22 patients (29 %) were Females. Mean age (Years) of the patients was 52 ±13.2 years with males and females as 53.11±13.45 and 50.18 ±11.71, respectively. Based on the 25 point CT scan chest severity score, 50 % (38 patients) were in the mild grade (1 -8) with a mean ±SD of 4.74±2.44, 43.42% (33 patients) were in the moderate grade (9 - 15) with a mean ±SD of 11.31 ± 2.06 and 6.58% (5 patients) were in the severe grade (16 -25) with a mean ±SD of 18.4 ± 3.29. The mean ±SD values of Serum Ferritin were 261.22±377.12ng/ml, 431.14 ±284.69ng/ml and 870.8±928.06ng/ml with mild, moderate and severe grade of CT chest severity score respectively. Statistically significant correlation was found between between the CT Chest Severity Score and Serum Ferritin levels. Conclusion: Serum ferritin levels were observed to be high in the CT scan chest positive group and so the serum ferritin levels measured at the time of admission predict radiological severity. This positive correlation between the CT Chest Severity Score and Serum Ferritin levels can predict clinical severity of Covid -19 disease with categorization into different risk groups helping in the clinical management, prevention of serious complications and disease outcome.