Radiologic findings of immunocompromised and immunocompetent COVID-19 patients with semi-quantitative chest CT score system

Abstract Background: As effects of immunosuppression are not still clear on COVID-19 patients, we conducted this study to identify clinical and laboratory findings associated with pulmonary involvement in both immunocompromised and immunocompetent patientsMethods: 107 immunocompromised and 107 immunocompetent COVID-19 patients matched for age and sex with either positive RT-PCR or clinical-radiological findings suggestive of COVID-19 enrolled in the study. Their initial clinical features, laboratory findings and chest CT scans, and short-term outcomes (hospitalization time and ICU admission) were recorded. In addition, pulmonary involvement was assessed with the semi-quantitative scoring system (0-25).Results: Pulmonary involvement was significantly lower in immunocompromised patients in contrast in immunocompetent patients especially in RLL (p-value=0.001), LUL (p-value=0.023), and both central and peripheral (p-value=0.002), and peribronchovascular (p-value=0.004) sites of lungs. Patchy (p-value<0.001), wedged (p-value=0.002), confluent (p-value=0.002) lesions with both ground glass and consolidation pattern (p-value<0.001) were significantly higher among immunocompetent patients.Initial sign and symptoms of immunocompromised patients including dyspnea (p-value=0.008) and hemoptysis (p-value=0.036*), respiratory rate of over 25 (p-value <0.001), and spo2 of below 93% (p-value= 0.01) was associated with higher pulmonary involvement. Total chest Ct score was also associated with longer hospitalization (p-value=0.016) and ICU admission (p-value=0.04) among immunocompromised patients.Conclusions: Immunocompromised patients had less severe pulmonary involvement, and initial clinical findings (dyspnea, hemoptysis, higher RR, and lower Spo2) could better predict pulmonary involvement than laboratory findings.