Abstract:To compare the performance of various CT reporting tools, including Zonal CT Visual Score (ZCVS), the number of involved lobes, and Radiological Society of North America (RSNA) categorization in predicting adverse outcomes among patients hospitalized due to lower respiratory symptoms during the COVID-19 pandemic. A total of 405 patients admitted with severe respiratory symptoms who underwent a chest CT were enrolled. The primary adverse outcome was ICU admission of patients. Predictive performances of reportin… Show more
“…The predominant CT findings mainly were ground-glass opacity and consolidation with a peripheral, bilateral, and widespread distribution similar to those previously reported. [8,[19][20][21][22][23][24][25] The development of consolidations was associated with the progression of the disease and was a warning sign for a serious course that was similar to One striking result of our study was that two-thirds of patients had vascular enlargement [Figure 2]. However, we found that consolidation and vascular enlargement were associated with a poor prognosis.…”
Section: Discussionsupporting
confidence: 72%
“…[5,20] Other unusual imaging findings included mediastinal and hilar lymph nodes, pleural effusion, pleural thickening, pneumothorax, pericardial effusion, cavitation, and pulmonary emphysema. [5,6,7,25] The presence of pleural effusion and pneumothorax was considered to be an important indicator of poor prognosis. [5] Unlike other studies, we found no association between pleural effusion and prognosis.…”
BACKGROUND AND AIM:We aimed to examine the demographic, clinical, and imaging characteristics of patients with COVID-19 pneumonia and also to identify the factors affecting mortality.
MATERIALS AND METHODS:This study was designed as a retrospective single-center observational study. A total of 126 patients with COVID-19 pneumonia who were polymerase chain reaction confirmed and underwent thorax computer tomography (CT) were analyzed. The patients' demographic and clinical data were obtained from the electronic medical record. Thorax CT findings were re-evaluated retrospectively by thoracic radiologists according to the severe acute respiratory syndrome coronavirus 2 pneumonia guidelines of the Radiological Society of North America. The extent of lesions was evaluated by CT lobe score, which was the sum of individual lobe scores (0-5 point) of the lungs.
RESULTS:The mean age of the patients was 60.4 ± 18.6 years and 54% (n = 68) were male. The most common symptoms included cough, fever, and shortness of breath. The average time interval between the onset of symptoms and thorax CT acquisition was 6.6 ± 8.3 days. The most common radiological findings included ground-glass opacity (98.4%), consolidation (72.2%), and vascular enlargement (69.8%), respectively. The deceased patients had more common consolidation, vascular enlargement, and high lobe scores in thorax CT as compared to survivors. According to logistic regression analysis age (P = 0.003), lobe score (P = 0.001), numbers of comorbidities (P = 0.017), symptoms duration (P = 0.034), and vascular enlargement (P = 0.045) were independent risk factors on 30-day mortality.
CONCLUSION:This study indicated that age, symptoms duration, the number of comorbidities, lobe score, and vascular enlargement in thorax CT are associated with the prognosis of COVID-19 pneumonia.
“…The predominant CT findings mainly were ground-glass opacity and consolidation with a peripheral, bilateral, and widespread distribution similar to those previously reported. [8,[19][20][21][22][23][24][25] The development of consolidations was associated with the progression of the disease and was a warning sign for a serious course that was similar to One striking result of our study was that two-thirds of patients had vascular enlargement [Figure 2]. However, we found that consolidation and vascular enlargement were associated with a poor prognosis.…”
Section: Discussionsupporting
confidence: 72%
“…[5,20] Other unusual imaging findings included mediastinal and hilar lymph nodes, pleural effusion, pleural thickening, pneumothorax, pericardial effusion, cavitation, and pulmonary emphysema. [5,6,7,25] The presence of pleural effusion and pneumothorax was considered to be an important indicator of poor prognosis. [5] Unlike other studies, we found no association between pleural effusion and prognosis.…”
BACKGROUND AND AIM:We aimed to examine the demographic, clinical, and imaging characteristics of patients with COVID-19 pneumonia and also to identify the factors affecting mortality.
MATERIALS AND METHODS:This study was designed as a retrospective single-center observational study. A total of 126 patients with COVID-19 pneumonia who were polymerase chain reaction confirmed and underwent thorax computer tomography (CT) were analyzed. The patients' demographic and clinical data were obtained from the electronic medical record. Thorax CT findings were re-evaluated retrospectively by thoracic radiologists according to the severe acute respiratory syndrome coronavirus 2 pneumonia guidelines of the Radiological Society of North America. The extent of lesions was evaluated by CT lobe score, which was the sum of individual lobe scores (0-5 point) of the lungs.
RESULTS:The mean age of the patients was 60.4 ± 18.6 years and 54% (n = 68) were male. The most common symptoms included cough, fever, and shortness of breath. The average time interval between the onset of symptoms and thorax CT acquisition was 6.6 ± 8.3 days. The most common radiological findings included ground-glass opacity (98.4%), consolidation (72.2%), and vascular enlargement (69.8%), respectively. The deceased patients had more common consolidation, vascular enlargement, and high lobe scores in thorax CT as compared to survivors. According to logistic regression analysis age (P = 0.003), lobe score (P = 0.001), numbers of comorbidities (P = 0.017), symptoms duration (P = 0.034), and vascular enlargement (P = 0.045) were independent risk factors on 30-day mortality.
CONCLUSION:This study indicated that age, symptoms duration, the number of comorbidities, lobe score, and vascular enlargement in thorax CT are associated with the prognosis of COVID-19 pneumonia.
“…While the use of chest CT to evaluate the prognosis of COVID-19 patients has been reported early in the pandemic ( 28 ), the criteria to define higher risk individuals was only proposed later. While some studies reported measures of time-to-improvement in repeated scans ( 28 ), most studies focused on quantification of lung involvement as a predictor of outcomes ( 29 - 32 ). In general, results are consistent across studies, though none of the prior reports includes individuals with prior disease.…”
The aim of our study was to validate the use of the standardized Radiological Society of North America (RSNA) reporting system in individuals with known lung cancer who presented to the emergency department with suspected COVID-19. We included patients aged 18 years or older from the Cancer Institute of the State of São Paulo (ICESP) with a confirmed diagnosis of lung cancer, admitted to the emergency department and undergoing chest computed tomography (CT) for suspicion of COVID-19. Comparison between SARS-CoV2 RT-PCR across RSNA categories was performed in all patients and further stratified by diagnosis of lung cancer progression. Among 58 individuals included in the analysis (65±9 years, 43% men), 20 had positive RT-PCR. Less than a half (43%) had no new lung findings in the CT. Positive RT-PCR was present in 75% of those with typical findings according to RSNA and in only 9% when these findings were classified as atypical or negative (P<0.001). Diagnostic accuracy was even higher when stratified by the presence or absence of progressive disease (PD). Extent of pulmonary inflammatory changes was strongly associated with higher mortality, reaching a lethality of 83% in patients with >25% of lung involvement and 100% when there was >50% of lung involvement. The lung involvement score was also highly predictive of prognosis in this population as was reported for non-lung cancer individuals. Collectively, our results demonstrated that diagnostic and prognostic values of chest CT findings in COVID-19 are robust to the presence of lung abnormalities related to lung cancer.
“…Some authors used semi-quantitative methods (assigning specific scores according to the percentage of involved parenchyma) to assess the prognostic value of baseline chest CT (Fig. 3 ) [ 44 ]. Fig.…”
Section: Chest Ct As a Prognostic Tool In Covid-19 Patientsmentioning
Infection with SARS-CoV-2 has dominated discussion and caused global healthcare and economic crisis over the past 18 months. Coronavirus disease 19 (COVID-19) causes mild-to-moderate symptoms in most individuals. However, rapid deterioration to severe disease with or without acute respiratory distress syndrome (ARDS) can occur within 1–2 weeks from the onset of symptoms in a proportion of patients. Early identification by risk stratifying such patients who are at risk of severe complications of COVID-19 is of great clinical importance. Computed tomography (CT) is widely available and offers the potential for fast triage, robust, rapid, and minimally invasive diagnosis: Ground glass opacities (GGO), crazy-paving pattern (GGO with superimposed septal thickening), and consolidation are the most common chest CT findings in COVID pneumonia. There is growing interest in the prognostic value of baseline chest CT since an early risk stratification of patients with COVID-19 would allow for better resource allocation and could help improve outcomes. Recent studies have demonstrated the utility of baseline chest CT to predict intensive care unit (ICU) admission in patients with COVID-19. Furthermore, developments and progress integrating artificial intelligence (AI) with computer-aided design (CAD) software for diagnostic imaging allow for objective, unbiased, and rapid assessment of CT images.
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