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Chest CT severity score and radiological patterns as predictors of disease severity, ICU admission, and viral positivity in COVID-19 patients
BACKGROUND: Chest computed tomography (CT) is a useful tool for the diagnosis of coronavirus disease-2019 (COVID-19), although its exact value for predicting critical illness remains unclear. This study evaluated the efficacy of chest CT to predict disease progression, pulmonary complications, and v...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Japanese Respiratory Society. Published by Elsevier B.V.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7972804/ https://www.ncbi.nlm.nih.gov/pubmed/33820751 http://dx.doi.org/10.1016/j.resinv.2021.02.008 |
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author | Bellos, Ioannis Tavernaraki, Kyriaki Stefanidis, Konstantinos Michalopoulou, Olympia Lourida, Giota Korompoki, Eleni Thanou, Ioanna Thanos, Loukas Pefanis, Angelos Argyraki, Aikaterini |
author_facet | Bellos, Ioannis Tavernaraki, Kyriaki Stefanidis, Konstantinos Michalopoulou, Olympia Lourida, Giota Korompoki, Eleni Thanou, Ioanna Thanos, Loukas Pefanis, Angelos Argyraki, Aikaterini |
author_sort | Bellos, Ioannis |
collection | PubMed |
description | BACKGROUND: Chest computed tomography (CT) is a useful tool for the diagnosis of coronavirus disease-2019 (COVID-19), although its exact value for predicting critical illness remains unclear. This study evaluated the efficacy of chest CT to predict disease progression, pulmonary complications, and viral positivity duration. METHODS: A single-center cohort study was conducted by consecutively including hospitalized patients with confirmed COVID-19. The chest CT patterns were described and a total severity score was calculated. The predictive accuracy of the severity score was evaluated using the receiver operating characteristic analysis, while a Cox proportional hazards regression model was implemented to identify the radiological features that are linked to prolonged duration of viral positivity. RESULTS: Overall, 42 patients were included with 10 of them requiring intensive care unit admission. The most common lesions were ground glass opacities (92.9%), consolidation (66.7%), and crazy-paving patterns (61.9%). The total severity score significantly correlated with inflammatory and respiratory distress markers, as well as with admission CURB-65 and PSI/PORT scores. It was estimated to predict critical illness with a sensitivity and specificity of 75% and 70%, respectively. Time-to-event analysis indicated that patients without ground-glass opacities presented significantly shorter median viral positivity (16 vs. 27 days). CONCLUSIONS: Chest CT severity score positively correlates with markers of COVID-19 severity and presents promising efficacy in predicting critical illness. It is suggested that ground-glass opacities are linked to prolonged viral positivity. Further studies should confirm the efficacy of the severity score and elucidate the long-term pulmonary effects of COVID-19. |
format | Online Article Text |
id | pubmed-7972804 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | The Japanese Respiratory Society. Published by Elsevier B.V. |
record_format | MEDLINE/PubMed |
spelling | pubmed-79728042021-03-19 Chest CT severity score and radiological patterns as predictors of disease severity, ICU admission, and viral positivity in COVID-19 patients Bellos, Ioannis Tavernaraki, Kyriaki Stefanidis, Konstantinos Michalopoulou, Olympia Lourida, Giota Korompoki, Eleni Thanou, Ioanna Thanos, Loukas Pefanis, Angelos Argyraki, Aikaterini Respir Investig Original Article BACKGROUND: Chest computed tomography (CT) is a useful tool for the diagnosis of coronavirus disease-2019 (COVID-19), although its exact value for predicting critical illness remains unclear. This study evaluated the efficacy of chest CT to predict disease progression, pulmonary complications, and viral positivity duration. METHODS: A single-center cohort study was conducted by consecutively including hospitalized patients with confirmed COVID-19. The chest CT patterns were described and a total severity score was calculated. The predictive accuracy of the severity score was evaluated using the receiver operating characteristic analysis, while a Cox proportional hazards regression model was implemented to identify the radiological features that are linked to prolonged duration of viral positivity. RESULTS: Overall, 42 patients were included with 10 of them requiring intensive care unit admission. The most common lesions were ground glass opacities (92.9%), consolidation (66.7%), and crazy-paving patterns (61.9%). The total severity score significantly correlated with inflammatory and respiratory distress markers, as well as with admission CURB-65 and PSI/PORT scores. It was estimated to predict critical illness with a sensitivity and specificity of 75% and 70%, respectively. Time-to-event analysis indicated that patients without ground-glass opacities presented significantly shorter median viral positivity (16 vs. 27 days). CONCLUSIONS: Chest CT severity score positively correlates with markers of COVID-19 severity and presents promising efficacy in predicting critical illness. It is suggested that ground-glass opacities are linked to prolonged viral positivity. Further studies should confirm the efficacy of the severity score and elucidate the long-term pulmonary effects of COVID-19. The Japanese Respiratory Society. Published by Elsevier B.V. 2021-07 2021-03-19 /pmc/articles/PMC7972804/ /pubmed/33820751 http://dx.doi.org/10.1016/j.resinv.2021.02.008 Text en © 2021 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved. 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. |
spellingShingle | Original Article Bellos, Ioannis Tavernaraki, Kyriaki Stefanidis, Konstantinos Michalopoulou, Olympia Lourida, Giota Korompoki, Eleni Thanou, Ioanna Thanos, Loukas Pefanis, Angelos Argyraki, Aikaterini Chest CT severity score and radiological patterns as predictors of disease severity, ICU admission, and viral positivity in COVID-19 patients |
title | Chest CT severity score and radiological patterns as predictors of disease severity, ICU admission, and viral positivity in COVID-19 patients |
title_full | Chest CT severity score and radiological patterns as predictors of disease severity, ICU admission, and viral positivity in COVID-19 patients |
title_fullStr | Chest CT severity score and radiological patterns as predictors of disease severity, ICU admission, and viral positivity in COVID-19 patients |
title_full_unstemmed | Chest CT severity score and radiological patterns as predictors of disease severity, ICU admission, and viral positivity in COVID-19 patients |
title_short | Chest CT severity score and radiological patterns as predictors of disease severity, ICU admission, and viral positivity in COVID-19 patients |
title_sort | chest ct severity score and radiological patterns as predictors of disease severity, icu admission, and viral positivity in covid-19 patients |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7972804/ https://www.ncbi.nlm.nih.gov/pubmed/33820751 http://dx.doi.org/10.1016/j.resinv.2021.02.008 |
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