COVID-19 pneumonia: Correlations between bacterial co-infections, clinical and radiological parameters

Abstract

The COVID-19 pandemic created a global health crisis, affecting millions of individuals.After the onset of respiratory symptoms and the identification of viral DNA, the evaluation of patients with COVID-19 includes radiological examinations, the disease extension can be estimated through scores corresponding to the percentage of expansion of pulmonary opacities. The aim of the research was to evaluate the correlation between bacterial co-infections, laboratory parameters and the degree of lung damage expressed by the Brixia score in the context of COVID-19 disease. We conducted a prospective study that included 144 adult patients diagnosed with COVID-19 by Ag or RT-PCR test. On chest X-ray, pneumonia was established in 78.5% of cases, the predominant radiological changes being the accentuated pulmonary pattern with presence of “ground glass” opacities (53.5%). Bacterial associations were isolated in 35.7%, the Chi-square test result demonstrating a weak and statistically insignificant association in relation with the degree of lung damage (χ2 = 1.818, p = 0.178). Hematological parameters, C-reactive protein and ferritin did not demonstrate significant correlations, only band neutrophils showed an increasing trend according to the Brixia score, but a weak one (ρ = 0.348, p = 0.009). Regarding the level of procalcitonin, the results are statistically insignificant (ρ = -0.001, p = 0.998). Bacterial co-infections, isolated in over a third of cases, did not demonstrate a correlation with the degree of lung damage. The severity of lung damage is not associated with hematological and inflammatory parameters, only band neutrophils showed a slight increase trend according to the Brixia score.