Assessing the relationship between CO-RADS scores and hemogram parameters in COVID-19

The Coronavirus disease 2019 (COVID-19) Reporting and Data System (CO-RADS) is a standardized Computed Tomography (CT) assessment tool for COVID-19 pneumonia. However, its correlation with hematological parameters needs further investigation. This study aimed to evaluate the relationship between CO-RADS scores and hemogram parameters in COVID-19 patients and assess their potential role in predicting disease severity. This retrospective study included 6,703 Polymerase Chain Reaction (PCR)-confirmed COVID-19 patients who presented to the emergency department between March 15 and June 15, 2020. Patients were classified according to CO-RADS scoring [1-5], and their demographic data, hemogram parameters, and CT findings were analyzed. The relationship between CO-RADS scores and laboratory parameters was evaluated, and ROC analysis was performed to determine cut-off values for predicting severe disease (CO-RADS 4-5). The mean age of patients was 56.8±17.2 years, and 48% were female. Analysis revealed significant correlations between CO-RADS scores and various hemogram parameters. Higher CO-RADS scores correlated with elevated white blood cell (WBC), neutrophils, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and monocyte-to-lymphocyte ratio (MLR), while lymphocytes decreased (p<0.001). ROC analysis identified NLR as the strongest predictor of severe involvement (AUC: 0.862, 95% CI: 0.844-0.880), with a cut-off value of 4.32 yielding 82.4% sensitivity and 76.8% specificity. PLR (cut-off: 245) also showed significant predictive value (AUC: 0.816), while MLR and lymphocyte count demonstrated lower predictive values (AUC: 0.712 and 0.742, respectively). The CO-RADS scoring system is strongly correlated with inflammatory markers and can serve as a reliable tool for assessing COVID-19 severity. The established cut-off values for NLR and PLR could be valuable in predicting severe disease, potentially aiding in clinical decision-making and patient triage. These findings suggest that integrating CO-RADS scoring with hemogram parameters might improve the assessment of COVID-19 severity in clinical practice.