Chest CT Characteristics are Strongly Predictive of Mortality in Patients with COVID-19 Pneumonia : A Multicentric Cohort Study

Copyright © 2022 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved..

RATIONALE AND OBJECTIVES: The novel coronavirus (COVID-19) has presented a significant and urgent threat to global health and there has been a need to identify prognostic factors in COVID-19 patients. The aim of this study was to determine whether chest computed tomography (CT) characteristics had any prognostic value in patients with COVID-19.

MATERIALS AND METHODS: A retrospective analysis of COVID-19 patients who underwent a chest CT-scan was performed in four medical centers. The prognostic value of chest CT results was assessed using a multivariable survival analysis with the Cox model. The characteristics included in the model were the degree of lung involvement, ground glass opacities, nodular consolidations, linear consolidations, a peripheral topography, a predominantly inferior lung involvement, pleural effusion, and crazy paving. The model was also adjusted on age, sex, and the center in which the patient was hospitalized. The primary endpoint was 30-day in-hospital mortality. A second model used a composite endpoint of admission to an intensive care unit or 30-day in-hospital mortality.

RESULTS: A total of 515 patients with available follow-up information were included. Advanced age, a degree of pulmonary involvement ≥50% (Hazard Ratio 2.25 [95% CI: 1.378-3.671], p = 0.001), nodular consolidations and pleural effusions were associated with lower 30-day in-hospital survival rates. An exploratory subgroup analysis showed a 60.6% mortality rate in patients over 75 with ≥50% lung involvement on a CT-scan.

CONCLUSION: Chest CT findings such as the percentage of pulmonary involvement ≥50%, pleural effusion and nodular consolidation were strongly associated with 30-day mortality in COVID-19 patients. CT examinations are essential for the assessment of severe COVID-19 patients and their results must be considered when making care management decisions.

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:29

Enthalten in:

Academic radiology - 29(2022), 6 vom: 10. Juni, Seite 851-860

Sprache:

Englisch

Beteiligte Personen:

Malécot, Nicolas [VerfasserIn]
Chrusciel, Jan [VerfasserIn]
Sanchez, Stéphane [VerfasserIn]
Sellès, Philippe [VerfasserIn]
Goetz, Christophe [VerfasserIn]
Lévêque, Henri-Paul [VerfasserIn]
Parizel, Elizabeth [VerfasserIn]
Pradel, Jean [VerfasserIn]
Almhana, Mouklès [VerfasserIn]
Bouvier, Elodie [VerfasserIn]
Uyttenhove, Fabian [VerfasserIn]
Bonnefoy, Etienne [VerfasserIn]
Vazquez, Guillermo [VerfasserIn]
Adib, Omar [VerfasserIn]
Calvo, Philippe [VerfasserIn]
Antoine, Colette [VerfasserIn]
Jullien, Veronique [VerfasserIn]
Cirille, Sylvia [VerfasserIn]
Dumas, Antoine [VerfasserIn]
Defasque, Anthony [VerfasserIn]
Ben Ghorbal, Yassine [VerfasserIn]
Elkadri, Marwan [VerfasserIn]
Schertz, Mathieu [VerfasserIn]
Cavet, Madeleine [VerfasserIn]

Links:

Volltext

Themen:

COVID-19
Chest CT
Journal Article
Mortality
Multicenter Study
Pneumonia
Teleradiology

Anmerkungen:

Date Completed 09.05.2022

Date Revised 16.07.2022

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.acra.2022.01.010

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM338137513