Prognostic Factors of Initial Chest CT Findings for ICU Admission and Mortality in Patients with COVID-19 Pneumonia

Abstract

Background: Studies have shown that CT could be valuable for prognostic issues in COVID-19. Objectives: To investigate the prognostic factors of early chest CT findings in COVID-19 patients. Methods: This retrospective study included 91 patients (34 women, and 57 men) of real-time reverse transcription polymerase chain reaction (RT-PCR) positive COVID-19 from three hospitals in Iran between February 25, 2020, to March 15, 2020. Patients were divided into two groups as good prognosis, discharged from the hospital and alive without symptoms (48 patients), and poor prognosis, died or needed ICU care (43 patients). The first CT images of both groups that were obtained during the first 8 days of the disease presentation were evaluated considering the pattern, distribution, and underlying disease. The total CT-score was calculated for each patient. Univariate and multivariate analysis with IBM SPSS Statistics v.26 was used to find the prognostic factors. Results: There was a significant correlation between poor prognosis and older ages, dyspnea, presence of comorbidities, especially cardiovascular and comorbidities. Considering CT features, peripheral and diffuse distribution, anterior and paracardiac involvement, crazy paving pattern, and pleural effusion were correlated with poor prognosis. There was a correlation between total CT-score and prognosis and an 11.5 score was suggested as a cut-off with 67.4% sensitivity and 68.7% specificity in differentiation of poor prognosis patients (patients who needed ICU admission or died). Multivariate analysis revealed that a model consisting of age, male gender, underlying comorbidity, diffused lesions, total CT-score, and dyspnea would predict the prognosis better. Conclusions: Total chest CT-score and chest CT features can be used as prognostic factors in COVID-19 patients. A multidisciplinary approach would be more accurate in predicting the prognosis.

Clinical characteristics, CT features and perinatal outcome of COVID-19 pneumonia in pregnant women and comparison with non-pregnant women

“…The latter difference could be attributed to the delay in performing CT exams in the pregnant group because of safety matters. The mortality or ICU admission rate of the two groups was different from previous studies (10,11,16,18,19). The prevalence of ICU admission and mortality rate was higher in the pregnant group in our study, which could be due to the delay in referring to the hospital.…”

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.…”

Association of chest CT severity score with mortality of COVID-19 patients: a systematic review and meta-analysis

“…Chest computed tomography (CT) is a high-sensitivity diagnostic tool for depicting interstitial pneumonia [10] and may lay a critical role in the evaluation of the severity and extent of pulmonary involvement. Bilateral multiple lobar ground-glass opacity and consolidation were the main chest CT findings on admission [11,12]. Other chest CT manifestations include crazy-paving patterns, multi-lobar involvement, and increasing lung consolidations with disease progress [12].…”

“…Bilateral multiple lobar ground-glass opacity and consolidation were the main chest CT findings on admission [11,12]. Other chest CT manifestations include crazy-paving patterns, multi-lobar involvement, and increasing lung consolidations with disease progress [12].…”