Chest CT Characteristics are Strongly Predictive of Mortality in Patients with COVID-19 Pneumonia: A Multicentric Cohort Study.

Content Provider	Europe PMC
Author	Malécot, Nicolas Chrusciel, Jan Sanchez, Stéphane Sellès, Philippe Goetz, Christophe Lévêque, Henri-Paul Parizel, Elizabeth Pradel, Jean Almhana, Mouklès Bouvier, Elodie Uyttenhove, Fabian Bonnefoy, Etienne Vazquez, Guillermo Adib, Omar Calvo, Philippe Antoine, Colette Jullien, Veronique Cirille, Sylvia Dumas, Antoine Defasque, Anthony Ben Ghorbal, Yassine Elkadri, Marwan Schertz, Mathieu Cavet, Madeleine
Copyright Year	2022
Abstract	Rationale and ObjectivesThe novel coronavirus (COVID-19) has presented a significant and urgent threat to global health and there has been a need to identify prognostic factors in COVID-19 patients. The aim of this study was to determine whether chest computed tomography (CT) characteristics had any prognostic value in patients with COVID-19.Materials and MethodsA retrospective analysis of COVID-19 patients who underwent a chest CT-scan was performed in four medical centers. The prognostic value of chest CT results was assessed using a multivariable survival analysis with the Cox model. The characteristics included in the model were the degree of lung involvement, ground glass opacities, nodular consolidations, linear consolidations, a peripheral topography, a predominantly inferior lung involvement, pleural effusion, and crazy paving. The model was also adjusted on age, sex, and the center in which the patient was hospitalized. The primary endpoint was 30-day in-hospital mortality. A second model used a composite endpoint of admission to an intensive care unit or 30-day in-hospital mortality.ResultsA total of 515 patients with available follow-up information were included. Advanced age, a degree of pulmonary involvement ≥50% (Hazard Ratio 2.25 [95% CI: 1.378-3.671], p = 0.001), nodular consolidations and pleural effusions were associated with lower 30-day in-hospital survival rates. An exploratory subgroup analysis showed a 60.6% mortality rate in patients over 75 with ≥50% lung involvement on a CT-scan.ConclusionChest CT findings such as the percentage of pulmonary involvement ≥50%, pleural effusion and nodular consolidation were strongly associated with 30-day mortality in COVID-19 patients. CT examinations are essential for the assessment of severe COVID-19 patients and their results must be considered when making care management decisions.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC8769941&blobtype=pdf
ISSN	10766332
Journal	Academic Radiology [Acad Radiol]
Volume Number	29
DOI	10.1016/j.acra.2022.01.010
PubMed Central reference number	PMC8769941
Issue Number	6
PubMed reference number	35282991
e-ISSN	18784046
Language	English
Publisher	The Association of University Radiologists. Published by Elsevier Inc.
Publisher Date	2022-01-20
Access Restriction	Open
Rights License	Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. © 2022 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
Subject Keyword	COVID-19 Chest CT Mortality Pneumonia Teleradiology SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2 COVID-19, Coronavirus Disease 19 CT, Computed Tomography GGO, Ground Glass Opacity RT-PCR, Reverse-transcription polymerase chain reaction ICU, Intensive care unit PE, Pulmonary embolism
Content Type	Text
Resource Type	Article
Subject	Radiology, Nuclear Medicine and Imaging