Risk of in-hospital death associated with Covid-19 lung consolidations on chest computed tomography – A novel translational approach using a radiation oncology contour software

Sapienza, Lucas Gomes; Nasra, Karim; Calsavara, Vinícius Fernando; Little, Tania; Narayana, Vrinda; Abu-Isa, Eyad

doi:10.1016/j.ejro.2021.100322

Cited by 8 publications

(5 citation statements)

References 29 publications

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“…Multivariate logistic (binary outcomes) and linear regression (continuous outcome) analyses were conducted to examine differences in hospital outcomes between OAs with typical versus atypical presentations, while controlling for variables known to contribute to mortality in the COVID-19 literature: age ( 22–24 ), gender ( 23 , 25 ), race ( 26 ), residence prior to hospital arrival ( 27 ), comorbidity index ( 25 ), MEWS ( 28 ), first documented oxygen ( 24 , 29 ), and DNR order ( 24 ). There were no statistically significant differences in hospital mortality, hospital LOS, or hospital readmission between typical and atypical presentations.…”

Section: Resultsmentioning

confidence: 99%

Patient Factors and Hospital Outcomes Associated With Atypical Presentation in Hospitalized Older Adults With COVID-19 During the First Surge of the Pandemic

Marziliano

Burns

Chauhan

et al. 2021

The Journals of Gerontology: Series A

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Background Literature indicates an atypical presentation of COVID-19 among older adults (OAs). Our purpose is to identify the frequency of atypical presentation and compare demographic and clinical factors, and short-term outcomes, between typical versus atypical presentations in OAs hospitalized with COVID-19 during the first surge of the pandemic. Methods Data from the inpatient electronic health record were extracted for patients aged 65 and older, admitted to our health systems’ hospitals with COVID-19 between March 1 and April 20, 2020. Presentation as reported by the OA or his/her representative is documented by the admitting professional and includes both symptoms and signs. Natural language processing was used to code the presence/absence of each symptom or sign. Typical presentation was defined as words indicating fever, cough, or shortness of breath; atypical presentation was defined as words indicating functional decline or altered mental status. Results Of 4 961 unique OAs, atypical presentation characterized by functional decline or altered mental status was present in 24.9% and 11.3%, respectively. Atypical presentation was associated with older age, female gender, Black race, non-Hispanic ethnicity, higher comorbidity index, and the presence of dementia and diabetes mellitus. Those who presented typically were 1.39 times more likely than those who presented atypically to receive intensive care unit–level care. Hospital outcomes of mortality, length of stay, and 30-day readmission were similar between OAs with typical versus atypical presentations. Conclusion Although atypical presentation in OAs is not associated with the same need for acute intervention as respiratory distress, it must not be dismissed.

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Section: Resultsmentioning

confidence: 99%

Patient Factors and Hospital Outcomes Associated With Atypical Presentation in Hospitalized Older Adults With COVID-19 During the First Surge of the Pandemic

Marziliano

Burns

Chauhan

et al. 2021

The Journals of Gerontology: Series A

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“…A medida que progresa la enfermedad, las consolidaciones se van resolviendo y pasan nuevamente a opacidades en vidrio deslustrado, mientras que su presencia persiste en los casos de síndrome de dificultad respiratoria aguda 7 . En algunos trabajos las consolidaciones se han relacionado con el desenlace de la enfermedad 10,11 . Aunque nosotros no encontramos tal asociación, su frecuencia coincidió con lo reportado en otras series 11 .…”

Section: Discussionunclassified

Asociación entre los hallazgos por tomografía computarizada y el desenlace de 44 pacientes oncológicos en cuidados paliativos, con COVID-19

Villaseñor-Navarro,

Rodríguez-González,

Sollozo-Dupont

2024

ARM

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Identificar patrones en tomografía computarizada (TC) que guarden relación con el score de letalidad en los pacientes oncológicos en cuidados paliativos. Método: Se incluyeron 44 pacientes con enfermedad por coronavirus 2019 (COVID-19) confirmada mediante prueba de reacción en cadena de la polimerasa-transcriptasa inversa. Veintidós de ellos fallecieron durante su estancia hospitalaria y 22 egresaron vivos. Los hallazgos tomográficos, incluyendo el score de severidad radiológico y las características clínicas, se compararon entre grupos. Resultados: La distribución de los hallazgos fue predominantemente difusa en los pacientes que fallecieron, en comparación con los que egresaron vivos (91 vs. 55%, p < 0.006), mientras que el derrame pleural se evidenció con mayor frecuencia entre los pacientes que fallecieron (55 vs. 9%, p < 0.001). El puntaje por TC fue más alto en los fallecidos en relación con los que egresaron vivos (12.4 ± 2.54 vs. 5.08 ± 3.37, p < 0.001). Un score de 9.5 en la tomografía parece ser un punto de corte óptimo para predecir mortalidad, con una sensibilidad del 90%, una especificidad del 91.7% y un área bajo la curva de 0.921. Conclusiones: Un score alto en la TC, el derrame pleural y la distribución difusa de las lesiones pulmonares son factores que pudieran relacionarse negativamente con la supervivencia de los pacientes oncológicos en cuidados paliativos con COVID-19.

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“…While the use of chest CT to evaluate the prognosis of COVID-19 patients has been reported early in the pandemic ( 28 ), the criteria to define higher risk individuals was only proposed later. While some studies reported measures of time-to-improvement in repeated scans ( 28 ), most studies focused on quantification of lung involvement as a predictor of outcomes ( 29 - 32 ). In general, results are consistent across studies, though none of the prior reports includes individuals with prior disease.…”

Section: Discussionmentioning

confidence: 99%

Validation of the North America expert consensus statement on reporting CT findings for COVID-19 in individuals with lung cancer

Peixoto

Neves

Generoso

et al. 2022

Braz J Med Biol Res

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The aim of our study was to validate the use of the standardized Radiological Society of North America (RSNA) reporting system in individuals with known lung cancer who presented to the emergency department with suspected COVID-19. We included patients aged 18 years or older from the Cancer Institute of the State of São Paulo (ICESP) with a confirmed diagnosis of lung cancer, admitted to the emergency department and undergoing chest computed tomography (CT) for suspicion of COVID-19. Comparison between SARS-CoV2 RT-PCR across RSNA categories was performed in all patients and further stratified by diagnosis of lung cancer progression. Among 58 individuals included in the analysis (65±9 years, 43% men), 20 had positive RT-PCR. Less than a half (43%) had no new lung findings in the CT. Positive RT-PCR was present in 75% of those with typical findings according to RSNA and in only 9% when these findings were classified as atypical or negative (P<0.001). Diagnostic accuracy was even higher when stratified by the presence or absence of progressive disease (PD). Extent of pulmonary inflammatory changes was strongly associated with higher mortality, reaching a lethality of 83% in patients with >25% of lung involvement and 100% when there was >50% of lung involvement. The lung involvement score was also highly predictive of prognosis in this population as was reported for non-lung cancer individuals. Collectively, our results demonstrated that diagnostic and prognostic values of chest CT findings in COVID-19 are robust to the presence of lung abnormalities related to lung cancer.

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Risk of in-hospital death associated with Covid-19 lung consolidations on chest computed tomography – A novel translational approach using a radiation oncology contour software

Cited by 8 publications

References 29 publications

Patient Factors and Hospital Outcomes Associated With Atypical Presentation in Hospitalized Older Adults With COVID-19 During the First Surge of the Pandemic

Patient Factors and Hospital Outcomes Associated With Atypical Presentation in Hospitalized Older Adults With COVID-19 During the First Surge of the Pandemic

Asociación entre los hallazgos por tomografía computarizada y el desenlace de 44 pacientes oncológicos en cuidados paliativos, con COVID-19

Validation of the North America expert consensus statement on reporting CT findings for COVID-19 in individuals with lung cancer

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