Risk Factors of Fatal Outcome in Patients With COVID-19 Pneumonia

Cellina, Michaela; Gibelli, Daniele; Pittino, Carlo Valenti; Toluian, Tahereh; Marino, Pietro; Oliva, Giancarlo

doi:10.1017/dmp.2020.346

Cited by 11 publications

(6 citation statements)

References 33 publications

(62 reference statements)

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“…Before beginning any medical therapy for patients with COVID-19, evaluation of the seriousness of the disease by a chest X-ray (CXR) performed at hospital admission should be considered. Imaging examination is widely claimed to play a pivotal role in COVID-19 management [ 7 - 9 ]. Currently, there are some established CXR scoring systems for quantifying lung abnormalities, including the Brixia and Radiographic Assessment of Lung Edema (RALE) classifications.…”

Section: Introductionmentioning

confidence: 99%

Correlation of Chest X-Ray Scores in SARS-CoV-2 Patients With the Clinical Severity Classification and the Quick COVID-19 Severity Index

Duc¹,

Thuy²,

Nam³

et al. 2022

Cureus

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Objectives This study aimed to assess the role of chest X-ray (CXR) scoring methods and their correlations with the clinical severity categories and the Quick COVID-19 Severity Index (qCSI). Methods We conducted a retrospective study of 159 COVID-19 patients who were diagnosed and treated at the University Medical Center between July and September 2021. Chest X-ray findings were evaluated, and severity scores were calculated using the modified CXR (mCXR), Radiographic Assessment of Lung Edema (RALE), and Brixia scoring systems. The three scores were then compared to the clinical severity categories and the qCSI using Spearman's correlation coefficient. Results Overall, 159 patients (63 males and 96 females) (mean age: 58.3 ± 15.7 years) were included. The correlation coefficients between the mCXR score and the Brixia and RALE scores were 0.9438 and 0.9450, respectively. The correlation coefficient between the RALE and Brixia scores was marginally higher, at 0.9625. The correlation coefficients between the qCSI and the Brixia, RALE, and mCXR scores were 0.7298, 0.7408, and 0.7156, respectively. The significant difference in the mean values of the three CXR scores between asymptomatic, mild, moderate, severe, and critical groups was also noted. Conclusions There were strong correlations between the three CXR scores and the clinical severity classification and the qCSI.

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Section: Introductionmentioning

confidence: 99%

Correlation of Chest X-Ray Scores in SARS-CoV-2 Patients With the Clinical Severity Classification and the Quick COVID-19 Severity Index

Duc¹,

Thuy²,

Nam³

et al. 2022

Cureus

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“…Systemic intermittent hypoxia is a life-threatening condition that happens in many diseases and situations, including chronic obstructive pulmonary disease, congestive heart failure and obstructive sleep apnea syndrome, all of which may coexist with SARS-CoV-2 infection in some patients. [30] As previously discussed, hypoxemia can appear in early stages of COVID-19. Hypoxia is a common feature in infl ammatory sites, which can eventually result in hypoxemia, leading in turn to induction of factors like HIF-1α.…”

Section: Perspective Peer Reviewedmentioning

confidence: 87%

“…HIF-1α is activated during the immune response and plays an important role at the infl ammation site by inducing proinfl ammatory cytokine production, leading to CS. [10,20,[23][24][25]30] All the evidence connecting hypoxemia with CS highlights the importance of avoiding the former in COVID-19 patients as early as possible, to prevent development of the latter, by using noninvasive ventilation (NIV), as described in the following section.…”

Section: Perspective Peer Reviewedmentioning

confidence: 99%

Hypoxemia and Cytokine Storm in COVID-19: Clinical Implications

Machado¹,

González‐Quevedo²

2021

MEDICC Review

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One of the most dreadful complications that can occur during the course of COVID-19 is the cytokine storm-also known as cytokine release syndrome-a form of systemic infl ammatory response syndrome triggered by SARS-CoV-2 infection.The cytokine storm is an activation cascade of auto-amplifying cytokines, which leads to excessive activation of immune cells and generation of pro-infl ammatory cytokines. It occurs when large numbers of white blood cells are activated and release infl ammatory cytokines, in turn activating even more white blood cells, fi nally resulting in an exaggerated pro-infl ammatory-mediated response and ineffective antiinfl ammatory control, leading to tissue damage, multiorgan failure, acute respiratory distress syndrome and death. Although cytokine storm pathogenesis is multifactorial, we hypothesize there is a close association between hypoxemia and cytokine storms in COVID-19, although it is diffi cult to establish the direction of this relationship. Most probably they coexist and, given enough time, one triggers the other in a chain reaction. Careful analysis of the day-to-day clinical evolution of COVID-19 indicates that there are short and slight periods of hypoxemia (confi rmed by pulse oximetry and arterial gasometry), even on the day of the onset of persistent cough and/or shortness of breath.We propose the use of continuous positive airway pressure in early stages of COVID-19, at the onset of respiratory symptoms. This non-invasive ventilation method may be useful in individualized treatments to prevent early hypoxemia in COVID-19 patients and thus avoid triggering a cytokine storm.We believe such an approach is relevant everywhere, and in Cuba in particular, since the country has initiated national production of mechanical ventilation systems, including non-invasive ventilators. Moreover, as Cuba's COVID-19 protocols ensure early patient admission to isolation centers or hospitals, clinicians can prescribe the early use of continuous positive airway pressure as soon as respiratory symptoms begin, averting early hypoxemia and its triggering effect on cytokine storm development, and consequently, avoiding acute respiratory distress syndrome, multi-organ failure, and death.

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“…Studies have shown chest radiographs of patients with DM to have increased bilateral airspace consolidation compared to patients without DM[ 12 , 13 ]. The severity of chest radiograph changes in patients with DM has indicated a significant correlation with mortality, as evidenced in multivariate analysis by Cellina et al [ 14 ]. Patients with bilateral peripheral alveolar disease (Figure 1 ) often present at a later stage and have a worse outcome.…”

Section: Literature Searchmentioning

confidence: 99%

Chest radiological finding of COVID-19 in patients with and without diabetes mellitus: Differences in imaging finding

Gangadharan¹,

Parker²,

Ahmed³

2022

WJR

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The pandemic of novel coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Diabetes mellitus is a risk factor for developing severe illness and a leading cause of death in patients with COVID-19. Diabetes can precipitate hyperglycaemic emergencies and cause prolonged hospital admissions. Insulin resistance is thought to cause endothelial dysfunction, alveolar capillary micro-angiopathy and interstitial lung fibrosis through pro-inflammatory pathways. Autopsy studies have also demonstrated the presence of microvascular thrombi in affected sections of lung, which may be associated with diabetes. Chest imaging using x-ray (CXR) and computed tomography (CT) of chest is used to diagnose, assess disease progression and severity in COVID-19. This article reviews current literature regarding chest imaging findings in patients with diabetes affected by COVID-19. A literature search was performed on PubMed. Patients with diabetes infected with SARS-CoV-2 are likely to have more severe infective changes on CXR and CT chest imaging. Severity of airspace consolidation on CXR is associated with higher mortality, particularly in the presence of co-morbidities such as ischaemic heart disease. Poorly controlled diabetes is associated with more severe acute lung injury on CT. However, no association has been identified between poorly-controlled diabetes and the incidence of pulmonary thromboembolism in patients with COVID-19.

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Risk Factors of Fatal Outcome in Patients With COVID-19 Pneumonia

Cited by 11 publications

References 33 publications

Correlation of Chest X-Ray Scores in SARS-CoV-2 Patients With the Clinical Severity Classification and the Quick COVID-19 Severity Index

Correlation of Chest X-Ray Scores in SARS-CoV-2 Patients With the Clinical Severity Classification and the Quick COVID-19 Severity Index

Hypoxemia and Cytokine Storm in COVID-19: Clinical Implications

Chest radiological finding of COVID-19 in patients with and without diabetes mellitus: Differences in imaging finding

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