Correlation Between Brixia Score Imaging and Clinical Laboratory Results In Severe-Critical Covid-19 Patients Receiving Standard Therapy Compared To Tocilizumab

Authors

  • Aulia Fitriani Department of Radiology,Faculty of Medicine Diponegoro University/Kariadi Hospital Semarang, Indonesia
  • Frederica Mardiana Wahyuni Department of Radiology,Faculty of Medicine Diponegoro University/Kariadi Hospital Semarang, Indonesia
  • Bambang Satoto Department of Radiology,Faculty of Medicine Diponegoro University/Kariadi Hospital Semarang, Indonesia
  • Thomas Handoyo Department of Internal Medicine, Faculty of Medicine, Diponegoro University/ Kariadi Hospital Semarang, Indonesia
  • Antonius Gunawan Santoso Department of Radiology,Faculty of Medicine Diponegoro University/Kariadi Hospital Semarang, Indonesia
  • Christina Hari Nawangsih Department of Radiology,Faculty of Medicine Diponegoro University/Kariadi Hospital Semarang, Indonesia
  • Nurdopo Baskoro Department of Radiology,Faculty of Medicine Diponegoro University/Kariadi Hospital Semarang, Indonesia

DOI:

https://doi.org/10.36408/mhjcm.v11i2.991

Keywords:

COVID-19, Brixia score, tocilizumab, convalescent plasma

Abstract

Background. Coronavirus infection disease 19 (COVID-19) is a global health issue. Brixia score and inflammatory markers can assess COVID-19 severity. Severe-critical phase becomes the main concern of clinicians in the management of COVID-19 to reduce mortality. Standard therapy for moderate to severe COVID-19 is convalescent plasma which functions as an antiviral and immunomodulator, while tocilizumab is an IL-6 antagonist which underlies the occurrence of cytokine storms in severe-critical COVID-19.

Aims. To examine the correlation between the Brixia score and clinical laboratory results in patients with severe-critical degree of Covid-19 who received both standard therapy and tocilizumab

Method. A retrospective cohort study of Brixia score, with clinical laboratory results of D-dimer, fibrinogen, ferritin, and CRP (C-reactive protein) COVID-19 patients with severe-critical phase who were administered standard therapy and tocilizumab who were treated at RSUP DR Kariadi Semarang, then a correlation was carried out between the Brixia score and clinical laboratory results using a correlation test Spearman.

Results. The research data consisted of 72 subjects divided into groups that were adiminstered tocilizumab therapy (36 subjects) and standard therapy (36 subjects). There was a significant correlation between the Brixia score and the D-dimer result with p = 0.024 (p <0.05), correlation coefficient = 0.377 in the standard pre-therapy and post therapy. A p-value of less than 0.05 indicates no significant correlation between the Brixia score and clinical laboratory results before or after tocilizumab therapy.

Conclusion. There is a significant correlation between the Brixia score results and the D-dimer results in COVID-19 patients who are adiministered standard therapy, but not significant correlation in tocilizumab

Downloads

Download data is not yet available.

References

 

1. Covid Distribution Data. 2021. COVID-19 management and national recovery committee. Diakses accessed 3 March 2021 from : https://covid19.go.id/

2. Sussana D. When will the COVID-19 Pandemic in Indonesia End?. 2020. Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal). 2020:1

3. Burhan E, Isbaniah F, Susanto AD, Aditama TY, All E. Pneumonia COVID- 19 Diagnonsis & Penatalaksanaan di Indonesia. Perhimpunan Dokter Paru Indonesia. Jakarta: Perhimpunan Dokter Paru Indonesia; 2020.

4. Strunk JL, Temesgen H, Andersen H, Packalen P. Imaging Profile of the COVID-19 Infection: Radiologic Findings and Literature Review Authors: 2014;80(2):1–8.

5. Kong W, Agarwal PP. Chest Imaging Appearance of Covid-19 Infection. 2009. p. 1–30

6. Mathew SR. Comparison of tocilizumab and convalescent plasma therapy for COVID-19: A systematic review. J Bio Sci. 2020;6:579-584

7. Sofic, A., et al (2022). Brixia Chest X-ray Severity Scoring System is in Relation with C-reactive Protein and D-dimer Values in Patients with COVID-19. Materia socio-medica, 34(2), 95–99. https://doi.org/10.5455/msm.2022.34.95-99

8. Perrone, F., TOCIVID-19 investigators, Italy (2020). Tocilizumab for patients with COVID-19 pneumonia. The single-arm TOCIVID-19 prospective trial. Journal of translational medicine, 18(1), 405. https://doi.org/10.1186/s12967-020-02573-9

9. Price, C. C., et al. (2020). Tocilizumab Treatment for Cytokine Release Syndrome in Hospitalized Patients With Coronavirus Disease 2019: Survival and Clinical Outcomes. Chest, 158(4), 1397–1408. https://doi.org/10.1016/j.chest.2020.06.006

10. Abolghasemi, H., et al. (2020). Clinical efficacy of convalescent plasma for treatment of COVID-19 infections: Results of a multicenter clinical study. Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis, 59(5), 102875. https://doi.org/10.1016/j.transci.2020.102875 Duan, K., et al. (2020). Effectiveness of convalescent plasma therapy in severe COVID-19 patients. Proceedings of the National Academy of Sciences of the United States of America, 117(17), 9490–9496. https://doi.org/10.1073/pnas.2004168117

11. Salazar, E., et al. (2020). Treatment of Coronavirus Disease 2019 (COVID-19) Patients with Convalescent Plasma. The American journal of pathology, 190(8), 1680–1690. https://doi.org/10.1016/j.ajpath.2020.05.014

12. Allahyari, A., et al. (2021). Efficacy and safety of convalescent plasma therapy in severe COVID-19 patients with acute respiratory distress syndrome. International immunopharmacology, 93, 107239. https://doi.org/10.1016/j.intimp.2020.107239

13. S L, G W. Examination Technique and Normal Findings. In: Radiology of Chest Disease. 3rd ed. New York: Thieme; 2007. p. 1–49

14. Jain V, Bhardwaj A. Pneumonia Pathology. NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health. Pennsylvania: StatPearls Publishing LLC; 2020

15. Sun J, He WT, Wang L, Lai A, Ji X, Zhai X, et al. COVID-19: Epidemiology, Evolution, and Cross-Disciplinary Perspectives. Trends Mol Med [Internet]. 2020;1– Available from: https://doi.org/10.1016/j.molmed.2020.02.008

16. Guo YR, Cao QD, Hong ZS, Tan YY, Chen SD, Jin HJ, et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak - an update on the status. Mil Med Res. 2020;7(1):11

17. Rojas, M., Rodríguez, Y., Monsalve, D. M., Acosta-Ampudia, Y., Camacho, B., Gallo, J. E., Rojas-Villarraga, A., Ramírez-Santana, C., Díaz-Coronado, J. C., Manrique, R., Mantilla, R. D., Shoenfeld, Y., & Anaya, J. M. (2020). Convalescent plasma in Covid-19: Possible mechanisms of action. Autoimmunity reviews, 19(7), 102554. https://doi.org/10.1016/j.autrev.2020.102554

18. Burhan E, Isbaniah F, Susanto AD, Aditama TY, All E. Pneumonia COVID- 19 Diagnonsis & Penatalaksanaan di Indonesia. Perhimpunan Dokter Paru Indonesia. Jakarta: Perhimpunan Dokter Paru Indonesia; 2020.

19. COVID-19 Clinical management. Living guidance 25 January 2021. World Health Organization. WHO/2019-nCoV/clinical/2021.1

20. Yang J, Zhou L, Yang Y, et al. Therapeutic and triage strategies for 2019 novel coronavirus disease in fever clinics. Lancet Respir Med 2020 Feb 13. doi:10.1016/S2213-2600(20)30071-0

Additional Files

Published

2024-07-31

How to Cite

1.
Fitriani A, Wahyuni FM, Satoto B, Handoyo T, Santoso AG, Nawangsih CH, Baskoro N. Correlation Between Brixia Score Imaging and Clinical Laboratory Results In Severe-Critical Covid-19 Patients Receiving Standard Therapy Compared To Tocilizumab. Medica Hospitalia J. Clin. Med. [Internet]. 2024 Jul. 31 [cited 2024 Oct. 9];11(2):188-92. Available from: http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/991

Issue

Section

Original Article

Citation Check