COVID-19 pneumonia in the emergency department: correlation of initial chest CT findings with short-term outcome

Abstract

Purpose Evaluate chest computed tomography (CT) findings of laboratory-confirmed Coronavirus Disease 2019 (COVID-19) cases and correlate it with clinical and laboratorial signs of severe disease and short-term outcome. Methods Chest CTs of 61 consecutive cases of COVID-19 disease that attended in our emergency department (ED) were reviewed. Three groups of patients classified according to the short-term follow-up were compared: (1) early-discharged from ED, (2) hospitalized on regular wards, and (3) admitted to intensive care unit (ICU). CT findings were also correlated with clinical and laboratorial features associated with severe disease. Results Median age was 52 years (IQR 39-63) with male predominance (60.7%). Most of the patients that did not require hospitalization had parenchymal involvement of less than 25% on CT (84.6%). Among hospitalized patients, interlobular septal thickening and extensive lung disease (> 50% of parenchyma) were significantly more frequent in ICU-admitted patients (P = 0.018 and P = 0.043, respectively). Interlobular septal thickening also correlated with longer ICU stay (P = 0.018). Low oxygen saturation (SpO 2 ≤ 93%) was associated with septal thickening (P = 0.004), diffuse distribution (P = 0.016), and pleural effusion (P = 0.037) on CT. All patients with > 50% of parenchymal involvement showed SpO 2 ≤ 93%. Elevated C-reactive protein (CRP) levels (> 5.0 mg/dL) correlated with consolidation (P = 0.002), septal thickening (P = 0.018), diffuse distribution (P = 0.020), and more extensive parenchymal involvement (P = 0.017). Conclusion Interlobular septal thickening on CT was associated with ICU admission and longer stay on ICU. Diffuse distribution, septal thickening, and more extensive lung involvement correlated with lower SpO 2 and higher CRP levels. Patients that needed hospitalization and ICU admission presented more extensive lung disease on CT.

Prevalence and clinical outcomes of pleural effusion in COVID‐19 patients: A systematic review and meta‐analysis

“…A total of 914 articles were additionally excluded after taking into consideration the title and abstract, generating 97 articles for adequate article review for conceivable consideration in this analysis. Eventually, 23 articles consisting of 6234 COVID‐19 positive patients were included in this meta‐analysis based on thorough evaluation and inclusion criteria 9,10,15–35 . The baseline characteristics of the included studies are outlined in Table 1.…”

Lower brachial artery flow-mediated dilation is associated with a worse prognosis and more lung parenchymal involvement in Covid-19: Prospective observational study

“…A total of 25% to 50% lung parenchyma involvement was accepted as Thorax CT 2. [ 11 ] The patients were grouped according to their gender, where the patients followed up (ward/ICU), the prognosis of the disease (discharged alive/non-survivors), involvement of the lung parenchyma (Thorax CT 1/Thorax CT 2/Thorax CT 3), and groups were compared in terms of FMD%. Peak values detected during hospitalization of the patients of ferritin, C-reactive protein (CRP), D-dimer, troponin, lactate dehydrogenase (LDH), and white blood cell count (WBC) were recorded.…”

COVID-19 pneumonia—ultrasound, radiographic, and computed tomography findings: a comprehensive pictorial essay

“…CT findings of COVID-19 infection are nonspecific, highly overlapping with those of other types of viral pneumonia []. Different imaging features and patterns have been described, as well as different time course and disease severity [ 23 24 25 ].…”

“…The most common findings are GGO, consolidation, and crazy paving appearance, with typical bilateral, peripheral, and basal in distribution [23][24][25]. Different imaging manifestations can be related to different examinations timing after the onset of the patients' symptoms, but maybe also correlated to different pre-existing patients' clinical characteristics/comorbidities.…”