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

Abstract

Background 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 CT characteristics had any prognostic value in patients with COVID-19. 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% Cl: 1.378 to 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. Conclusions 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.

Admission Predictors of Mortality in Hospitalized COVID-19 Patients—A Serbian Cohort Study

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CT Image of Consolidation and Ground-Glass Opacification (GGO) of COVID-19 in Diabetic Patient

“…Clinical improvement is usually found after 2 weeks associated with a gradual resolution of the consolidative opacification. Regarding lung abnormalities in COVID-19 for survival analysis, the characteristic findings were predominant inferior lung involvement, nodular consolidations, linear consolidations, GGO, peripheral topography, and others [17]. From summarized data (n=515), pulmonary involvement degree (≥50%) and advanced age, nodular consolidations showed a Hazard Ratio of 2.25 for lower survival rates of 30 days in the hospital.…”

Interhospital Transfer Versus Other Modes of Admission of Patients With Covid-19 at the University Hospital Andohatapenaka: “a Retrospective Cohort Study”

“…In the present study, for patients admitted by interhospital transfer, there was a signi cant association between the degree of lung involvement greater than 50% and the occurrence of mortality, with RR [95% CI] = 1.99 [1.05-3.74] and p = 0.022. According to a study by Malécot et al, the extent of lesions greater than 50% on CT was correlated with the risk of mortality, and this risk was greater if the patient was over 75 years of age [13]. This relationship between lung involvement and mortality underlines the importance of chest CT in the management of COVID-19 infection.…”