Prediction of prognosis in patients with severe COVID-19 pneumonia using CT score by emergency physicians: a single-center retrospective study

Abstract

We aimed to develop a method to determine the CT score that can be easily obtained from CT images and examine its prognostic value for severe COVID pneumonia. Patients with COVID pneumonia who required ventilatory management by intubation were included. CT score was based on anatomical information in axial CT images and were divided into three sections of height from the apex to the bottom. The extent of pneumonia in each section was rated from 0 to 5 and summed. The primary outcome was the prediction of patients who died or were managed on extracorporeal membrane oxygenation (ECMO) based on the CT score at admission. Of the 71 patients included, 12 (16.9%) died or required ECMO management, and the CT score predicted death or ECMO management with ROC of 0.718 (0.561–0.875). The death or ECMO versus survival group (median [quartiles]) had a CT score of 17.75 (14.75–20) versus 13 (11–16.5), p = 0.017. In conclusion, a higher score on our generated CT score could predict the likelihood of death or ECMO management. A CT score at the time of admission allows for early preparation and transfer to a hospital that can manage patients who may need ECMO.

Prognostic value of SOFA combined with chest CT severity score in patients with critical COVID-19 pneumonia: a retrospective study

“…CT-SS can indicate the extent to which the COVID-19 pneumonia image is occupied, and the value of CT-SS in predicting the prognosis of COVID-19 patients has been reported by several studies [9][10][11][12][13][14][34][35]. Similar to a moderate predictive value of CT-SS alone with a AUC of 0.718 for in-hospital mortality in patients with severe COVID-19 pneumonia [9], our current study also showed that the AUC of CT-SS was only 0.790 for in-hospital mortality of COVID-19 patients. The unsatisfactory predictive value of CT-SS for COVID-19 outcomes is related to its inevitable limitations.…”

“…Chest CT severity score calculation CT-SS was performed using the semiquantitative method [9,19], which was also shown in Fig. 1.…”

“…Second, chest CT, as a widely used and noninvasive image, plays an important role in the diagnosis of COVID-19 pneumonia [7,8]. Chest CT severity score (CT-SS) has been recognized as an important method to assess the severity of lung involvement and disease prognosis, but its predictive validity is equally unsatisfactory [9,14]. Third, reverse transcription-polymerase chain reaction (RT-PCR) for nasopharyngeal swab detection remains the diagnostic standard for COVID-19, and the dynamic alteration of cycling threshold (Ct) values of SARS-CoV-2 can be considered as a prognostic marker for COVID-19 pneumonia [15].…”

Follow-up evaluation of pulmonary function and computed tomography findings in chronic kidney disease patients after COVID-19 infection

“…Using a Picture Archiving and Communication System (PACS; EV Insite version 3.11.1.500; PSP Corporation, Japan), three radiologists with 9, 10, and 14 years of experience performed consensus interpretations blinded to the patients’ clinical information. The evaluators assessed the presence of the following CT patterns; consolidation, ground-glass opacities (focal, multifocal, diffuse), mosaic attenuation patterns (hypoattenuating and hyperattenuating areas), perilobular consolidation (organizing pneumonia-like pattern), reticulations, architectural distortion, honeycombing, traction bronchiectasis, pneumatocele, curvilinear lines, nodules, and pleural thickening or pleural effusion [ 15 ]. Additional findings were annotated separately.…”

The Prognostic Utility of Cytokines in Hospitalized COVID-19 Patients

“…Most SARS-CoV-2-infected patients develop only a mild, self-limiting disease. However, approximately 15–20% of COVID-19 patients develop severe pneumonia, and 5–10% need intensive care treatment [ 3 , 4 , 5 ].…”