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01.12.2021 | COVID-19 | Research article | Ausgabe 1/2021 Open Access

BMC Infectious Diseases 1/2021

The association between clinical laboratory data and chest CT findings explains disease severity in a large Italian cohort of COVID-19 patients

BMC Infectious Diseases > Ausgabe 1/2021
Simone Canovi, Giulia Besutti, Efrem Bonelli, Valentina Iotti, Marta Ottone, Laura Albertazzi, Alessandro Zerbini, Pierpaolo Pattacini, Paolo Giorgi Rossi, Rossana Colla, Tommaso Fasano, on behalf of the Reggio Emilia COVID-19 Working Group;
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The online version contains supplementary material available at https://​doi.​org/​10.​1186/​s12879-021-05855-9.

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Laboratory data and computed tomography (CT) have been used during the COVID-19 pandemic, mainly to determine patient prognosis and guide clinical management. The aim of this study was to evaluate the association between CT findings and laboratory data in a cohort of COVID-19 patients.


This was an observational cross-sectional study including consecutive patients presenting to the Reggio Emilia (Italy) province emergency rooms for suspected COVID-19 for one month during the outbreak peak, who underwent chest CT scan and laboratory testing at presentation and resulted positive for SARS-CoV-2.


Included were 866 patients. Total leukocytes, neutrophils, C-reactive protein (CRP), creatinine, AST, ALT and LDH increase with worsening parenchymal involvement; an increase in platelets was appreciable with the highest burden of lung involvement. A decrease in lymphocyte counts paralleled worsening parenchymal extension, along with reduced arterial oxygen partial pressure and saturation. After correcting for parenchymal extension, ground-glass opacities were associated with reduced platelets and increased procalcitonin, consolidation with increased CRP and reduced oxygen saturation.


Pulmonary lesions induced by SARS-CoV-2 infection were associated with raised inflammatory response, impaired gas exchange and end-organ damage. These data suggest that lung lesions probably exert a central role in COVID-19 pathogenesis and clinical presentation.
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