Evaluation of the relationship between inpatient COVID-19 mortality and chest CT severity score

Abstract

Objectives There is scarce data available on the prognostic application of chest CT. The main purpose of this study was to evaluate the performance of a semi-quantitative CT severity score in identifying the risk of mortality in COVID-19 patients. Methods This retrospective cohort study was performed on 262 hospitalized COVID-19 patients. The CT severity score was assessed by two independent radiologists using a method previously used to score the severity of acute respiratory distress syndrome on thin slice lung CT. Results Multivariate regression analysis showed increasing odds of in-hospital death associated with older age, and the presence of coronary artery disease at the time of admission. The mean CT severity score was 7.5 in the survivor group and 14.5 in the deceased group. Overall, the lower zones were the most frequently affected sites in COVID-19. There was significant difference between the survivor and deceased groups regarding CT severity scores. Multivariate regression analysis showed increasing odds of in-hospital death associated with higher CT severity score at admission. Conclusions Our results show that mortality was significantly higher in patients with higher CT severity score even after adjustment for clinical, demographics and laboratory parameters. However, this study is performed retrospectively and needs to be validated in a prospective study.

Machine learning-based prognostic modeling using clinical data and quantitative radiomic features from chest CT images in COVID-19 patients

“…Both left and right lung were divided into three zones including carina upper level, between the carina and inferior pulmonary vein, and below the inferior pulmonary vein level [ 6 , [41] , [42] , [43] ]. Then, we separately evaluated each zone involvement and scored between 0 and 4 (0: no involvement, 1: 1%-25% involved, 2: 26%-50% involved, 3: 51%-75% involved, and 4: 76%-100% involved) [ 6 , [41] , [42] , [43] , [44] , [45] , [46] ]. The total involvement score (Inv.Score) was calculated by summing up different zones scores.…”

A Pictorial Review of the Role of Imaging in the Detection, Management, Histopathological Correlations, and Complications of COVID-19 Pneumonia

“…The prognostic value of CT has been reported by several studies [ 145 , 146 , 147 , 148 , 149 , 150 , 151 , 152 , 153 , 154 , 155 , 156 , 157 , 158 , 159 , 160 ]. The use of a CT severity score (CT-SS) may be useful to standardize the assessment of lung alterations in COVID-19 pneumonia and to stratify patient risk and predict short-term outcomes [ 108 , 145 , 148 , 150 , 151 , 152 ].…”

“…Tabatabaei et al [ 148 ] reported that CT-SS is a reliable predictive factor of mortality in previously healthy non-elderly individuals with COVID-19 pneumonia. Abbasi et al [ 158 ] found a significant correlation between time of admission to time of death and CT-SS, and between CT-SS and time to ICU admission. These authors also found that mortality was significantly higher in patients with higher CT-SS, even after adjustments for clinical, demographic, and laboratory parameters.…”

The effect of cardiovascular disease and acute cardiac injury on fatal COVID-19: a meta-analysis

“…As of March 19, 2021, 223 countries or regions were involved, more than 120.9 million confirmed cases were diagnosed, and these numbers have continued to increase [ 1 ]. The global mortality rate of COVID-19 is approximately 2.2% [ 1 ], while the mortality rate of hospitalized COVID-19 cases is commonly over 10.0% [ [2] , [3] , [4] ]. This is because hospitalized patients tend to have a more serious condition and generally require more effective and special therapies than those in isolation at home.…”

“…The Society of Cardiology [ 5 ] and the American College of Cardiology [ 6 ] strongly recommend careful cardiac assessment of symptomatic COVID-19 cases. Some primary studies also mentioned two potentially major cardiac risk factors that might be related to the severity of COVID-19 infection [ [2] , [3] , [4] ]. One risk factor is baseline cardiovascular disease (CVD), which is defined as a group of disorders of the heart and blood vessels, such as coronary heart disease, peripheral arterial disease, and congenital heart disease [ 7 ], occurring before COVID-19 infection and causing more serious clinical outcomes.…”