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Association of “initial CT” findings with mortality in older patients with coronavirus disease 2019 (COVID-19)
OBJECTIVES: To investigate the association of chest CT findings with mortality in clinical management of older patients. METHODS: From January 21 to February 14, 2020, 98 older patients (≥ 60 years) who had undergone chest CT scans (“initial CT”) on admission were enrolled. Manifestation and CT scor...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7283986/ https://www.ncbi.nlm.nih.gov/pubmed/32524220 http://dx.doi.org/10.1007/s00330-020-06969-5 |
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author | Li, Yan Yang, Zhenlu Ai, Tao Wu, Shandong Xia, Liming |
author_facet | Li, Yan Yang, Zhenlu Ai, Tao Wu, Shandong Xia, Liming |
author_sort | Li, Yan |
collection | PubMed |
description | OBJECTIVES: To investigate the association of chest CT findings with mortality in clinical management of older patients. METHODS: From January 21 to February 14, 2020, 98 older patients (≥ 60 years) who had undergone chest CT scans (“initial CT”) on admission were enrolled. Manifestation and CT score were compared between the death group and the survival group. In each group, patients were sub-grouped based on the time interval between symptom onset and the “initial CT” scan: subgroup1 (interval ≤ 5 days), subgroup2 (interval between 6 and 10 days), and subgroup3 (interval > 10 days). Adjusted ROC curve after adjustment for age and gender was applied. RESULTS: Consolidations on CT images were more common in the death group (n = 46) than in the survival group (n = 52) (53.2% vs 32.0%, p < 0.001). For subgroup1 and subgroup2, a higher mean CT score was found for the death group (33.0 ± 17.1 vs 12.9 ± 8.7, p < 0.001; 38.8 ± 12.3 vs 24.3 ± 11.9, p = 0.002, respectively) and no significant difference of CT score was identified with respect to subgroup3 (p = 0.144). In subgroup1, CT score of 14.5 with a sensitivity of 83.3% and a specificity of 77.3% for the prediction of mortality was an optimal cutoff value, with an adjusted AUC of 0.881. In subgroup2, CT score of 27.5 with a sensitivity of 87.5% and a specificity of 70.6% for the prediction of mortality was an optimal cutoff value, with an adjusted AUC of 0.895. CONCLUSIONS: “Initial CT” scores may be useful to speculate prognosis and stratify patients. Severe manifestation on CT at an early stage may indicate poor prognosis for older patients with COVID-19. KEY POINTS: • Severe manifestation on CT at an early stage may indicate poor prognosis for older patients with COVID-19. • Radiologists should pay attention to the time interval between symptom onsets and CT scans of patients with COVID-19. • Consolidations on CT images were more common in death patients than in survival patients. |
format | Online Article Text |
id | pubmed-7283986 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-72839862020-06-10 Association of “initial CT” findings with mortality in older patients with coronavirus disease 2019 (COVID-19) Li, Yan Yang, Zhenlu Ai, Tao Wu, Shandong Xia, Liming Eur Radiol Chest OBJECTIVES: To investigate the association of chest CT findings with mortality in clinical management of older patients. METHODS: From January 21 to February 14, 2020, 98 older patients (≥ 60 years) who had undergone chest CT scans (“initial CT”) on admission were enrolled. Manifestation and CT score were compared between the death group and the survival group. In each group, patients were sub-grouped based on the time interval between symptom onset and the “initial CT” scan: subgroup1 (interval ≤ 5 days), subgroup2 (interval between 6 and 10 days), and subgroup3 (interval > 10 days). Adjusted ROC curve after adjustment for age and gender was applied. RESULTS: Consolidations on CT images were more common in the death group (n = 46) than in the survival group (n = 52) (53.2% vs 32.0%, p < 0.001). For subgroup1 and subgroup2, a higher mean CT score was found for the death group (33.0 ± 17.1 vs 12.9 ± 8.7, p < 0.001; 38.8 ± 12.3 vs 24.3 ± 11.9, p = 0.002, respectively) and no significant difference of CT score was identified with respect to subgroup3 (p = 0.144). In subgroup1, CT score of 14.5 with a sensitivity of 83.3% and a specificity of 77.3% for the prediction of mortality was an optimal cutoff value, with an adjusted AUC of 0.881. In subgroup2, CT score of 27.5 with a sensitivity of 87.5% and a specificity of 70.6% for the prediction of mortality was an optimal cutoff value, with an adjusted AUC of 0.895. CONCLUSIONS: “Initial CT” scores may be useful to speculate prognosis and stratify patients. Severe manifestation on CT at an early stage may indicate poor prognosis for older patients with COVID-19. KEY POINTS: • Severe manifestation on CT at an early stage may indicate poor prognosis for older patients with COVID-19. • Radiologists should pay attention to the time interval between symptom onsets and CT scans of patients with COVID-19. • Consolidations on CT images were more common in death patients than in survival patients. Springer Berlin Heidelberg 2020-06-10 2020 /pmc/articles/PMC7283986/ /pubmed/32524220 http://dx.doi.org/10.1007/s00330-020-06969-5 Text en © European Society of Radiology 2020 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. |
spellingShingle | Chest Li, Yan Yang, Zhenlu Ai, Tao Wu, Shandong Xia, Liming Association of “initial CT” findings with mortality in older patients with coronavirus disease 2019 (COVID-19) |
title | Association of “initial CT” findings with mortality in older patients with coronavirus disease 2019 (COVID-19) |
title_full | Association of “initial CT” findings with mortality in older patients with coronavirus disease 2019 (COVID-19) |
title_fullStr | Association of “initial CT” findings with mortality in older patients with coronavirus disease 2019 (COVID-19) |
title_full_unstemmed | Association of “initial CT” findings with mortality in older patients with coronavirus disease 2019 (COVID-19) |
title_short | Association of “initial CT” findings with mortality in older patients with coronavirus disease 2019 (COVID-19) |
title_sort | association of “initial ct” findings with mortality in older patients with coronavirus disease 2019 (covid-19) |
topic | Chest |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7283986/ https://www.ncbi.nlm.nih.gov/pubmed/32524220 http://dx.doi.org/10.1007/s00330-020-06969-5 |
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