4. DISCUSSION
According the findings of the present study, it seems that there is a
significant relationship between chest CT scan characteristics and change
clinical parameters with outcomes of COVID-19 cases. Based on this
results ground Glass Opacity (GGO) and consolidation were the most
common chest CT scan findings, which was match to other researches21,22. The most common location of abnormalities was
lower zone involvement that observed more than upper zone, which was
consistent with findings of other studies 19,23. An
investigation carried out on other patients show that CT reports will be
more obvious, when revealed longer the onset of symptoms24. In this study radiological patterns have
correlation with the stages of the development disease, which was in
match to the studies 24,25. The findings of this study
indicated ALT, AST, CRP, NEU, LDH, and Urea have very good accuracy in
predicting cases with positive RT-PC R for COVID-19, respectively. Also,
liver injury is more prevalent in severe cases compared to mild cases of
COVID-19. This study was similar to study Chen et al. Another study
indicated that 2–11%of patients with COVID-19 had ALT and AST levels
during progression of COVID-19 disease 19. In
comparison to the normal range, in patients with positive RT-PCR
COVID19, the rate of WBC and LYM counts was decreased and NEU counts
increase, which is in line with another study 26. The
COVID -19 Virus extensive through the respiratory system and infected
immune cells and causing changes in number of peripheral white blood
cells such as lymphocytes 27. Various studies proposed
the substantial decrease in the number of lymphocytes following
infection with the coronavirus that influence immune cells and prevent
immune action 28. Also, others report show that high
neutrophil count and LDH level in COVID-19 patients were autonomous
predictors of an adverse clinical outcome 29. The
results of laboratory parameters in this study, such as ALT, CRP, AST,
LDH, and NEU indicated that there could be used to foretell the presence
of COVID-19 disease, while WBC were poor predicted of the disease. This
information is match to findings reported by Wang et al.30 and Gao et al. 31. Thus, some
laboratory parameters can use to screening cases with positive RT-PCR
forCOVID-19. Overall, Clinical course of the COVID-19 disease is
unforeseeable, due to the heterogeneity of its manifestations and multi
organ failure. At present, there are no prognostic biological markers to
identify Covid 19 patients and estimate their associated mortality. It
seems that predicting CT scan reports of disease progression and its
relationship with laboratory-clinical findings may be useful in patient
triage and symptomatic treatment of patients 32. In
this study we used a previously CT score for confirming this
presumption, that it was based on the lobar Involvement expanse of as
reported by Pan et al 33. The results of the study
shown correlation CT scoring with laboratory parameters, age, dyspnea at
admission and the presence of pre-existing comorbidities like coronary
arteries and diabetes. Information of mortality rate in this study have
approved the outstanding importance of age and its rate in patients
older than 75 years. our finding in the study substantially assessment
CT parenchymal reports and may reflect short and high-term outcome
through direct visualization of anatomic damages than with non-specific
laboratory parameters and inflammatory biomarkers. Based on clinical
criteria provided by the WHO 34 and as expected,
finding of this study indicated the correlation of disease severity with
CT reports and laboratory parameters, so CT scores were significantly
confirmed high correlation between imaging findings and clinical stages,
however, the diagnostic role of CT scan and its correlation to
laboratory parameters is controversial and debated. Although, the use of
CT is as a first line test, but highly sensitive imaging method like CT
associated with specific clinical parameters, might be beneficial to
speed up diagnostic and therapeutic workflow.