The Risk Factors of Pulmonary Involvement Patterns and Their Association with Covid-۱۹ Severity in Hospitalized Patients

Backgrounds: Although several studies evaluated the risk factors of Covid-۱۹ severity, there is a lack of findings about the role of pulmonary involvement patterns in the condition of patients. The present study aimed to evaluate the prevalence of different Computed Tomography (CT)-scan patterns and their difference in the condition of patients.Methods and materials: ۳۸۴ eligible patients who were admitted to the Covid-۱۹ ward of Valiasr hospital of Fasa, from April, ۱۸th, to September, ۱۷th, ۲۰۲۰, were included in the study. After exclusion of the patient with incomplete data, no CT scan, and outliers, the data of ۳۹۲ remained patients were analyzed with ANCOVA and logistic regression test. Age, gender, hypertension, diabetes, infarction, fever, days of symptoms before admission, headache, lethargy, and cough were considered confounding factors .Results: The mean age of patients was ۵۶.۷±۰.۹ with ۱۸۰ men (۵۰.۳%). The involvement patterns were grand glass opacity (GG, n=۱۶۷), patchy consolidation (PC, n=۵۴), crazy paving (CP, n=۴۸), peripheral stripe-like (PSL, n=۱۶), nodular (n=۱۷) and normal (n=۶۰). The highest pulmonary involvement was observed in CP (۴۴.۸±۳.۴, CI: [۶.۳۳, ۲۳.۸۵]) in comparison with other groups. The patients with nodular patterns were referred on the lowest days (۴.۷۶±۰.۹۸, CI: [-۳.۴۷, ۰.۱۳]). The lowest and highest oxygen saturation were observed in GG (۸۸.۳±۷.۴, CI: [۸۷.۲, ۸۹.۴]) and PSL (۹۱.۲±۰.۹, CI: [۸۹.۴, ۹۳.۰]) patterns. The vaccinated patients had the lowest chance for nodular patterns (OR:۰.۵۳, CI: [۰.۱۵, ۱.۸۵]) and the highest chance for PSL (OR:۲.۲۴, CI: [۰.۴۳, ۱۱.۶۰]). Adjusting for confounding factors made no difference in the significance of the results.Conclusion: Although the most of patients represented a GG pattern with the lowest oxygen saturation, CP patterns showed the highest pulmonary involvement. Vaccination shifted the involvement to lower severities, but there are several remaining controversies in our findings .