Coronavirus disease 2019 (COVID-19), which has rapidly spread worldwide since the Northern Hemisphere spring of 2020, remains uncontrolled even after 3 years. The pathophysiology of COVID-19 involves acute lung injury (ALI) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with early manifestations including acute hypoxemic respiratory failure (AHRF) associated with lung damage [1,2]. The primary treatment approach is respiratory therapy based on oxygen inhalation. In addition to pharmacological treatment, mechanical ventilation (MV) and extracorporeal membrane oxygenation [3,4] have been established in the management of severe COVID-19. Chest computed tomography (CT) imaging has been frequently employed in the diagnosis of COVID-19 pneumonia and determination of the severity of pneumonia. Especially during the early stages of the pandemic, when the pathophysiology, disease progression, and treatment strategies of COVID-19 were unclear, chest CT imaging contributed significantly to the accurate diagnosis of COVID-19 pneumonia [5,6].

As noted above, chest CT images are used to assess the severity of COVID-19 pneumonia [7,8]. During the early stages of the COVID-19 pandemic, the limited understanding of the disease pathophysiology led to imaging examinations of even mild cases as part of screening efforts. In the current stage of the pandemic, however, in which COVID-19 disease progression and established treatment strategies are known and SARS-CoV-2 from the attenuated omicron subvariant leads to COVID-19, it would be appropriate to perform chest CT scans only on patients with suspected COVID-19 pneumonia because the costs and potential harm to patients from radiation exposure cannot be ignored.

To gain an understanding of the pathology by similar noninvasive methods, it would be advantageous to estimate radiological ALI using other physiological or biochemical blood test results. This approach would help to avoid unnecessary radiation exposure and achieve a cost-effective diagnosis. In this study, we conducted a multiple logistic regression analysis to predict ALI in patients with COVID-19 pneumonia from actual chest CT images as the dependent variable using oxygenation indices, blood test results, and other clinical indicators.