Relation entre le Stade Clinique et les Signes Scanographiques de la COVID-19 à l’Hôpital Gynéco-Obstétrique et Pédiatrique de Douala

RESUME Introduction. Le but de cette etude etait de decrire les lesions scanographiques thoraciques associees aux signes cliniques de la maladie a coronavirus 2019 (COVID-19). Materiels et methodes. Les examens scanographiques de 132 patients atteints de la COVID-19 ont ete analyses retrospectivement par trois radiologues dans notre centre hospitalier, d’Avril a Juillet 2020. Les resultats ont ete correles aux donnees cliniques de 50 patients chez qui les dossiers etaient complets. Resultats. Les opacites en « verre depoli » associees a des condensations parenchymateuses etaient les lesions les plus repandues, notamment chez les patients avec un etat clinique modere a severe, et chez qui, on retrouvait egalement aspect de crazy paving. Les atteintes avaient tendance a etre bilaterales, peripheriques, et inferieures. Parmi les differentes caracteristiques cliniques associees au stade modere a severe, la dyspnee etait le seul facteur independant de severite de l’infection par la COVID-19, avec un Odd’s ratio (IC a 95%) de 19,621 (1,776-216,759), p = 0,015. Conclusion. Cette etude preliminaire a permis de relever les principales caracteristiques scanographiques des patients atteints de COVID-19 dans notre milieu, et de discuter une association avec quelques signes cliniques chez certains patients, pouvant ainsi participer a l'evaluation de la gravite de la maladie. ABSTRACT Introduction. are the most common in. Chest computed tomography (CT) is useful for the diagnosis pulmonary manifestations of SARS-CoV-2 virus disease due to its high sensitivity and for the follow-up of patients. Given the persistence of this pandemic we conducted this study with aim to describe and compare the clinical stages of SARS-CoV-2 pneumonia with the chest CT features in a referral hospital in Douala. Materials and methods. Chest CT scans of 132 patients tested positive for COVID-19 with RT-PCR were analyzed retrospectively from April to July 2020. CT findings were compared with clinical data from 50 patients with complete records. Results. Of the 132 patients’ records included, 95 (72%) had bilateral lung involvement which were widespread in 81 (61.4%) patients, with a peripheral distribution in 60 (45.5%) patients, and consisted mainly of ground-glass opacities with lung consolidation in 67 (50.8%) cases. CT findings of 28 (21.2%) patients were classified as severe. Dyspnea was associated with CT severity in 33 patients (66.0%) during the univariate and multivariate analyses with odds ratios (95% CI) of 8.4 (2.0-10.8) and 8.2 (1.2-54.7) respectively, p = 0.030. Conclusion. Bilateral peripheral ground-glass opacities and lung consolidation are the most frequent chest CT findings of SARS-CoV-2 pneumonia. Dyspnea was significantly associated with chest CT severity and is therefore an important prognostic factor.