Lésions Tomodensitométriques chez les patients hospitalisés pour  pneumonie à COVID-19  lors de  la première vague de la pandémie à SARS-COV-2 aux Cliniques Universitaires de Kinshasa (RDC)

Tshienda, Frederick Tshibasu; Tshikwela, Michel Lelo; Risasi, Jean-Robert Makulo; Situakibanza, Hippolyte Nani Tuma; Salem, R.; Ndjock, Patrick Sekele Marob; Makwala, René Ngiyulu; Aundu, Antoine Molua; Mabiala, Joseph Bodi; Ntumba, Jean‐Marie Kayembe; Longo-Mbenza, Benjamin

doi:10.11604/pamj.2021.39.230.29311

Cited by 2 publications

(2 citation statements)

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“…Cases of pulmonary embolism were not observed in our study. This is also the case in several studies published by African authors [ 11 – 14 ]. In our situation, this can be explained by the fact that these chest CT from the first day of hospital admission were not repeated.…”

Section: Discussionsupporting

confidence: 72%

“…In Africa, DR Congo in particular, only a few hospitals used chest CT in the diagnosis and the management of patients suspected of COVID-19. They mainly reported bilateral peripheral ground-glass opacities in 60-69% of patients, crazy paving in 19-67%, and consolidation lesions in 58-80% [ 11 – 13 ]. These studies had small sample sizes.…”

Section: Introductionmentioning

confidence: 99%

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Interest of Chest CT to Assess the Prognosis of SARS-CoV-2 Pneumonia: An In-Hospital-Based Experience in Sub-Saharan Africa

Obe -A- Ndzem Holenn,

Mazoba,

Mukanga

et al. 2024

Pulmonary Medicine

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Background and Objectives. The chest computed tomography (chest CT) has played an important role in the management of COVID-19. Few data on its use in sub-Saharan Africa (SSA) are reported. The objectives of this study conducted in Kinshasa, DR Congo, were to describe the lung lesions on day 1 of hospitalization in patients admitted for suspected COVID-19 and to identify those that were most associated with SARS-CoV-2 infection/RT-PCR and the determinants of chest CT associated with death. Methods. We included all patients with respiratory symptoms (dyspnea, fever, and cough) and/or respiratory failure admitted to the SOS Médecins de nuit SARL hospital, DR Congo, during the 2nd and 3rd waves of the COVID-19 pandemic. The diagnosis of COVID-19 was established based on RT-PCR anti-SARS-CoV-2 tests (G1 (RT-PCR positive) vs. G2 (RT-PCR negative)), and all patients had a chest CT on the day of admission. We retrieved the digital files of patients, precisely the clinical, biological, and chest CT parameters of the day of admission as well as the vital outcome (survival or death). Chest CT were read by a very high-definition console using Advantage Windows software and exported to the hospital network using the RadiAnt DICOM viewer. To determine the threshold for the percentage of lung lesions associated with all-cause mortality, we used ROC curves. Factors associated with death, including chest CT parameters, were investigated using logistic regression analysis. Results. The study included 200 patients (average age 56.2±15.2 years; 19% diabetics and 4.5% obese), and COVID-19 was confirmed among 56% of them (G1). Chest CT showed that ground glass (72.3 vs. 39.8%), crazy paving (69.6 vs. 17.0%), and consolidation (83.9 vs. 22.7%), with bilateral and peripheral locations (68.8 vs. 30.7%), were more frequent in G1 vs. G2 (p<0.001). No case of pulmonary embolism and fibrosis had been documented. The lung lesions affecting 30% of the parenchyma were informative in predicting death (area under the ROC curve at 0.705, p=0.017). In multivariate analysis, a percentage of lesions affecting 50% of the lung parenchyma increased the risk of dying by 7.194 (1.656-31.250). Conclusion. The chest CT demonstrated certain characteristic lesions more frequently in patients in whom the diagnosis of COVID-19 was confirmed. The extent of lesions affecting at least half of the lung parenchyma from the first day of admission to hospital increases the risk of death by a factor of 7.

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Section: Discussionsupporting

confidence: 72%

Section: Introductionmentioning

confidence: 99%