Relationship between CT Severity Score and Capillary Blood Oxygen Saturation in Patients with COVID-19 Infection

Aalinezhad, Marzieh; Alikhani, Fariba; Akbari, Pooya; Rezaei, Mostafa Haji; Soleimani, Samira; Hakamifard, Atousa

doi:10.5005/jp-journals-10071-23752

Cited by 23 publications

(18 citation statements)

References 24 publications

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“…Another study also confirmed that severe/critical patients with respiratory rate ≥ 30 times/min and SpO2 of 93% or less in a resting state had higher total CT scores than ordinary COVID-19 patients [ 23 ]. Aalinezhad [ 24 ] and Osman[ 25 ] et al also reported higher chest CT score is inversely associated with O2 saturation. Furthermore, a multicenter cohort study demonstrated that consolidation in upper lungs on the initial chest CT of COVID-19 patients was associated with increased odds of adverse endpoints, including SpO2 < 93% and partial arterial pressure of oxygen less than 60 mm Hg on room air [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Predictors of the chest CT score in COVID-19 patients: a cross-sectional study

Yazdi

Ghadery

SeyedAlinaghi

et al. 2021

Virol J

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Background Since the COVID-19 outbreak, pulmonary involvement was one of the most significant concerns in assessing patients. In the current study, we evaluated patient’s signs, symptoms, and laboratory data on the first visit to predict the severity of pulmonary involvement and their outcome regarding their initial findings. Methods All referred patients to the COVID-19 clinic of a tertiary referral university hospital were evaluated from April to August 2020. Four hundred seventy-eight COVID-19 patients with positive real-time reverse-transcriptase-polymerase chain reaction (RT-PCR) or highly suggestive symptoms with computed tomography (CT) imaging results with typical findings of COVID-19 were enrolled in the study. The clinical features, initial laboratory, CT findings, and short-term outcomes (ICU admission, mortality, length of hospitalization, and recovery time) were recorded. In addition, the severity of pulmonary involvement was assessed using a semi-quantitative scoring system (0–25). Results Among 478 participants in this study, 353 (73.6%) were admitted to the hospital, and 42 (8.7%) patients were admitted to the ICU. Myalgia (60.4%), fever (59.4%), and dyspnea (57.9%) were the most common symptoms of participants at the first visit. A review of chest CT scans showed that Ground Glass Opacity (GGO) (58.5%) and consolidation (20.7%) were the most patterns of lung lesions. Among initial clinical and laboratory findings, anosmia (P = 0.01), respiratory rate (RR) with a cut point of 25 (P = 0.001), C-reactive protein (CRP) with a cut point of 90 (P = 0.002), white Blood Cell (WBC) with a cut point of 10,000 (P = 0.009), and SpO2 with a cut point of 93 (P = 0.04) was associated with higher chest CT score. Lung involvement and consolidation lesions on chest CT scans were also associated with a more extended hospitalization and recovery period. Conclusions Initial assessment of COVID-19 patients, including symptoms, vital signs, and routine laboratory tests, can predict the severity of lung involvement and unfavorable outcomes.

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Section: Discussionmentioning

confidence: 99%

Predictors of the chest CT score in COVID-19 patients: a cross-sectional study

Yazdi

Ghadery

SeyedAlinaghi

et al. 2021

Virol J

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“…For example, Gemicioglu B. et al demonstrated a high SpO2 level of 92.57 ± 7.1% in COPD patients with COVID-19 infection [ 32 ]. At the same time, Aalinezhad M. et al has concluded that COPD was linked to more profound hypoxemia in patients with COVID-19-associated pneumonia (89.83 ± 8.02) [ 33 ]. Lee et al in the nationwide retrospective study in South Korea has shown an increased rate of ICU admission, mechanical ventilation and all-cause mortality in the COPD group [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of COPD on clinical and CT characteristics of COVID-19-associated pneumonia: single tertiary center experience

Filippenko

Zagurovskaya

Abdrakhmanova³

et al. 2022

Egypt J Radiol Nucl Med

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Background The severe acute respiratory syndrome-related coronavirus 2 pandemic continues to this day worldwide. Individuals with COPD are at increased risk of contracting SARS-CoV-2. Most of the conducted studies are based on the clinical assessment of COVID-19 infection with different comorbidities. The specific contribution of COPD to the severity of the disease and outcome still remains the point of investigation. The main goals of our study are to assess COPD’s influence on the severity of clinical and CT characteristics of COVID-19 pneumonia and associated in-hospital mortality. Results This is a retrospective study on 281 patients with RT-PCR-confirmed COVID-19 infection and CT spectrum of COVID-19 pneumonia. Fifty patients have COPD based on CT criteria. No significant difference was observed in the mean hospital length of stay, arterial oxygen saturation on admission or in-hospital mortality between COPD and non-COPD groups. Patients with COPD were two times less likely to have fever less than 37.9 °C (RR = 2.037; 95% CI 1.114–3.724, p = 0.016), but higher absolute neutrophil count (p = 0.033) and median level of neutrophil/lymphocyte ratio (p = 0.029). The COPD group was presented with milder CT severity score (especially CT1, less than 25% of lung involvement) (p = 0.022), less likely to have bilateral (RR = 2.601; 95% CI: 1.341–5.044, p = 0.023) or central (RR = 1.754; 95% CI 1.024–3.003, p = 0.046) distribution of ground-glass opacities, right lower lobe (RR = 2.887; 95% CI 1.574–5.293, p = 0.008) or left lung (RR = 2.627; 95% CI 1.448–4.765, p = 0.009) involvement, and “crazy-paving” pattern (RR = 2.208; 95% CI 1.292–3.774, p = 0.003). Both moderate positive and negative relationship was observed between CT1, CT4, hypoxia and in-hospital mortality in the COPD group (r = − 0.383, p = 0.033; r = 0.486, p = 0.007; r = − 0,354, p = 0,022, respectively). Conclusion The presence of COPD by imaging criteria in the settings of COVID-19-associated pneumonia did not significantly influence the clinical or imaging performance of the patients, nor was it linked to the increased in-hospital mortality.

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“…Other studies applied crude CT scoring systems. For example, Wang et al used 0:0%; 1:1–49%; 2:50–75%; 3: > 75%; range 0–3; global score 0–15 [ 16 ]; Hu et al used 0:0%; 1:1–25%; 2:26–50%; 3:51–75%; 4:76–100%; range 0–4; global score 0–20 [ 17 – 21 ]; Francone et al used 0:0%; 1: < 5%; 2:5–25%; 3:26–50%; 4:51–75%; 5: > 75%; range 0–5; global score 0–25 [ 22 , 23 ]; Zhao et al used 0:0%; 1: < 25%; 2:25–49%; 3:50–74%; 4: ≥ 75%; range 0–4; global score 0–24 [ 24 – 26 ]; Aalinezhad et al used another system (0:0%; 1: < 50%; 2: > 50%; range 0–2; global score 0–40) [ 27 , 28 ]. Similarly, Guillo et al used a scoring system of 0–10%, 11–25%, 26–50%, 51–75% and 76–100% ground-glass opacities and consolidation [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

“…This is consistent with the previous studies reporting that clinical characteristics including patient age and coexisting condition, immune status, body temperature and exposure history may be related to CT imaging in patients with viral pneumonia including SARS and COVID-19 [ 2 , 9 , 30 , 31 ]. In addition, Aalinezhad et al’s study also showed a significant inverse relationship between CT severity score and SpO 2 [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Associations between CT pulmonary opacity score on admission and clinical characteristics and outcomes in patients with COVID-19

et al. 2021

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This study investigated associations between chest computed tomography (CT) pulmonary opacity score on admission and clinical features and outcomes in COVID-19 patients. The retrospective multi-center cohort study included 496 COVID-19 patients in Jiangsu province, China diagnosed as of March 15, 2020. Patients were divided into four groups based on the quartile of pulmonary opacity score: ≤ 5%, 6–20%, 21–40% and 41% +. CT pulmonary opacity score was independently associated with age, single onset, fever, cough, peripheral capillary oxygen saturation, lymphocyte count, platelet count, albumin level, C-reactive protein (CRP) level and fibrinogen level on admission. Patients with score ≥ 41% had a dramatic increased risk of severe or critical illness [odds ratio (OR), 15.58, 95% confidence interval (CI) 3.82–63.53), intensive care unit (ICU)] admission (OR, 6.26, 95% CI 2.15–18.23), respiratory failure (OR, 19.49, 95% CI 4.55–83.40), and a prolonged hospital stay (coefficient, 2.59, 95% CI 0.46–4.72) compared to those with score ≤ 5%. CT pulmonary opacity score on admission, especially when ≥ 41%, was closely related to some clinical characteristics and was an independent predictor of disease severity, ICU admission, respiratory failure and long hospital stay in patients with COVID-19.

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Relationship between CT Severity Score and Capillary Blood Oxygen Saturation in Patients with COVID-19 Infection

Cited by 23 publications

References 24 publications

Predictors of the chest CT score in COVID-19 patients: a cross-sectional study

Predictors of the chest CT score in COVID-19 patients: a cross-sectional study

Impact of COPD on clinical and CT characteristics of COVID-19-associated pneumonia: single tertiary center experience

Associations between CT pulmonary opacity score on admission and clinical characteristics and outcomes in patients with COVID-19

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