Methodology
The study conformed to the principles of the Declaration of Helsinki and
was approved by the ethics committee of
Mugla Sitki Kocman University.
Patients with pneumonia who needed hospitalization at Mugla Sitki Kocman
University University Education and Training Hospital were analyzed
retrospectively.
Adult patients hospitalized with a diagnosis of pneumonia between March
15, 2020 and July 1, 2020 were evaluated.
The patients with previously diagnosed anemia, chronic renal failure,
chronic obstructive pulmonary disease, liver parenchymal disease,
malignancies and chronic gastrointestinal inflammation were excluded.
The remaining 205 patients were included in the study. A case-control
study was planned with the collected data. The case group was defined as
pneumonia with PCR-confirmed SARS-CoV-2 and the control group consisted
of patients with non-COVID-19 pneumonia.
Biomarkers of anemia and iron metabolism (hemoglobin, serum iron,
ferritin, total iron-binding capacity (TIBC), transferrin saturation,
MCV, MCH, RDW, RET-He, C-reactive protein (CRP), procalcitonin (PCT)
were analyzed.
Demographic features, thoracic computed tomography (CT) findings, oxygen
saturation (SpO2), respiratory symptoms, development of acute
respiratory distress syndrome (ARDS), intensive care unit (ICU)
admission, duration of hospitalization, discharge status (event free
survival or death) were evaluated.
CT findings of the patients with COVID-19 pneumonia were analyzed
advancedly. All thoracic CT scans were obtained without contrast agent
injection, during deep inspiration, in the supine position and sometimes
in the prone position. Radiological images were obtained with 256-slice
Toshiba-TCT-60 AX and 4-slice Siemens Somatom device localized in the
emergency room for COVID-19 patients only.
The following technical parameters were used:
Tube voltage: 120 kV; tube current modulation 100-250 mAs; spiral pitch
factor: 0.98; collimation width: 0.625.
The decontamination protocol for the chamber consisted of surface
disinfection with 62-71% ethanol or 0.1% sodiumhypochlorite. Passive
air exchange was performed for 40-60 minutes after chest CT examination
in each patient.
CT images were transferred to the VIA port system in the workstation of
our hospital and 3D reconstruction was performed. Images were evaluated
on high resolution medical screen.
Right lung 3 lobes left lung 2 lobes were examined separately. Each lobe
was accepted as 20% and lobe volume was measured first. Then, the areas
in the consolidated and groundglass area were calculated by calculating
the volumetricv oxel on the computer, and they were calculated over the
total volume. Total lung aeration loss was found by summing the
percentage values of all lobes.
Statistical Analysis
Data was analyzed using IBM SPSS Statistics Version 23.0. All tests were
two-tailed and p-value<0.05 was statistically significant. The
descriptive statistics are presented as frequencies, percentage, mean,
standard deviation (SD) values. Variables are depicted as n (%) or
means. Student’s t-test, Mann–Whitney-U test, or chi-square tests were
performed to test for significant differences between groups. The
relationships between variables were evaluated using the Pearson or
Spearman correlation tests. Logistic regression analysis was performed
to analyze the effects of risk factors.