Cardiopulmonary Imaging Utilization and Findings among Hospitalized COVID-19 Patients in Latin America

Abstract

Objectives: Describe the use and findings of cardiopulmonary imaging-chest X-ray (cX-ray), echocardiography (cEcho), chest CT (cCT), lung ultrasound (LUS), and/or cardiac magnetic resonance imaging (cMRI)-in COVID-19 hospitalizations in Latin America (LATAM). Background:There is a lack of information on the images used and their findings during the SARS-CoV-2 pandemic in LATAM.Methods: Multicenter, prospective, observational study of COVID-19 inpatients, conducted from March to December 2020, from 12 high-complexity centers, in nine LATAM countries. Adults (>18 years) with at least one imaging modality performed, followed from admission until discharge and/or in-hospital death, were included. Results:We studied 1,435 hospitalized patients (64% males) with a median age of 58 years classified into three regions: Mexico (Mx), 262; Central America and Caribbean (CAC), 428; and South America (SAm), 745. More frequent comorbidities were overweight/obesity, hypertension, and diabetes. During hospitalization, 58% were admitted to the ICU. The in-hospital mortality was 28%, and it was highest in Mx (37%).The most frequent images performed were cCT (61%), mostly in Mx and SAm, and cX-ray (46%), significant in CAC. The cEcho was carried out in 18%, similarly among regions, and LUS was carried out in 7%, with a higher frequently in Mx. Abnormal findings on the cX-ray were peripheral or basal infiltrates, and in cCT abnormal findings were the ground glass infiltrates, more commonly in Mx. In LUS, interstitial syndrome was the most abnormal finding, predominantly in Mx and CAC.Renal failure was the most prevalent complication (20%), predominant in Mx and SAm. Heart failure developed in 13%, predominant in Mx and CAC. Lung thromboembolism was higher in Mx while myocardial infarction was in CAC.Logistic regression showed associations of abnormal imaging findings and their severity, with comorbidities, complications, and evolution. Conclusions:The use and findings of cardiopulmonary imaging in LATAM varied between regions and had a great impact on diagnosis and prognosis.

Latin-American Registry of Cardiovascular Disease and COVID-19: Final Results

“…We also had a greater number of rehospitalization than reported in SEMI-COVID-19 (3.9% vs 7.3%). Deficient treatment, high comorbidities, and a poor healthcare system contributed to the higher mortality rate in LA&C. The study performed by Spina et al [33] identified similar results in mortality and comorbidities which reflected the severe circumstances of our population that could influence those rates.…”

Avaliação de alterações em tomografia computadorizada de tórax de pacientes internados por Covid-19

“…A magnitude do acometimento pulmonar, assim como a associação com outros achados de imagens (consolidação, espessamento septal e derrame pleural) e comorbidades, estiveram relacionados a pior prognóstico do paciente, com maior frequência de óbitos nos grupos com essas alterações com relação aos pacientes que não apresentaram. O que pode ser explicado por denotarem maior gravidade ao quadro do paciente, visto que esses achados sugerem um prejuízo à expansão e ventilação pulmonar, levantando a hipótese sobre o impacto que a fisioterapia respiratória poderia ocasionar na evolução da internação 2,8 .…”