Achados tomográficos do tórax em doentes com COVID-19 e associação com os estágios evolutivos temporais

Abstract

Covid-19 infection was considered a pandemic and has brought great advances in research worldwide. Accurate diagnosis is performed by RT-PCR, but computed tomography (CT) of the chest has helped in the early diagnosis of pulmonary alterations and collaborates in the assessment of the patient's severity. Studies are needed to understand the pathophysiology of the disease and offer the best treatment for affected patients. The main objective of this study was to correlate the main clinical, laboratory and CT imaging changes in patients confirmed by SARS-COV-2 infection. Observational analytical study of the historical cohort type carried out in a private hospital in the city of Maceió, Alagoas, Brazil. The final sample consisted of 390 patients with positive RT-PCR for Covid-19 with laboratory tests and CT available. The most frequent initial symptoms were cough (66,9%), fever (59%), dyspnea (45,6%) and headache (45,1%), and the most common comorbidities were systemic arterial hypertension (66, 5%), diabetes mellitus (34,9%), obesity (32,1%), heart disease (18,1%) and asthma (9,3%). Were found 22% normal CT scans, being more frequent in the initial periods of the disease, with 34% of CT scans being normal until the 3rd day of the onset of symptoms, demonstrating the importance of performing the exam in the appropriate period. Of the altered exams, opacity with ground-glass attenuation was the most found (99%). There was a significant association between older age, comorbidities, positive tomographic findings, opacities with ground-glass attenuation, mosaic paving and percentage of pulmonar involvement with death. In the temporal evolutionary analysis of the disease, there was a significant association with laboratory data (CRP and platelets), ground glass and mosaic paving with the evolutionary stage in relation to the days of symptom onset. Covid-19 is a relatively new and still little-known pathology, which reinforces the need for in-depth and detailed studies on its temporal evolution, as well as its clinical, laboratory and imaging correlation, aiming to offer the patient a quality multidisciplinary care, increasing the chances of recovery.