Avaliação de gravidade nos pacientes com COVID-19 por meio da tomografia computadorizada de tórax: um estudo retrospectivo com pacientes do HUPE

Abstract

Coronavirus disease 19 (COVID-19) is a viral infection first described at the end of 2019 in Wuhan, China. Due to its rapid spread, in March 2020, it was classified as a pandemic by the World Health Organization (WHO). The syndrome is called coronavirus disease-19 (COVID-19), caused by the SARS-CoV-2 virus. In adults, the main concern is severe clinical outcomes. Recent evidence shows that a wide variety of symptoms persist after the initial or subacute phase of the disease, characterizing post-COVID syndrome. According to the WHO, this is defined by signs and symptoms related to COVID-19, generally, three months after the onset of the infectious condition and which persist for at least two months, the most common symptoms being fatigue, difficulty breathing, and cognitive dysfunction. This work aimed to study possible associations between outcomes and changes found in CT scans of patients who had COVID-19 at the Hospital Universitário Pedro Ernesto (HUPE). This is a retrospective, observational, and cross-sectional study of adult patients who underwent reverse transcription polymerase chain reaction (PCR-RT) tests and chest computed tomography (CT) at HUPE. Data and image collection lasted from April 2020 to June 2021, and convenience-defined sampling. The results showed the most frequent symptoms: cough, dyspnea, fever, myalgia, chest pain, anosmia and odynophagia. It was observed that the most common tomographic changes, in decreasing order of frequency, were ground glass, consolidations, mosaic paving, parenchymal bands, peribronchovascular consolidations, bronchial ectasia, subpleural lines, nodule with ground glass halo, architectural distortion and band in frosted glass. Regarding the association between epidemiological, tomographic and clinical findings with mortality, it was noted that age equal to or greater than 60 years and comorbidities constituted risk factors for deaths resulting from COVID-19. Regarding tomographic parameters, there was a higher risk of death in patients who had higher percentages of parenchymal involvement and an indeterminate and atypical tomographic pattern. In this context, the present study does not dispute the relevance of serological tests for confirming COVID-19 infection but emphasizes the role of imaging tests in decision-making on the treatment protocol to be adopted, given the slowness of test results.