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Imaging-based indices combining disease severity and time from disease onset to predict COVID-19 mortality: A cohort study

BACKGROUND: COVID-19 prognostic factors include age, sex, comorbidities, laboratory and imaging findings, and time from symptom onset to seeking care. PURPOSE: The study aim was to evaluate indices combining disease severity measures and time from disease onset to predict mortality of COVID-19 patie...

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Autores principales: Besutti, Giulia, Djuric, Olivera, Ottone, Marta, Monelli, Filippo, Lazzari, Patrizia, Ascari, Francesco, Ligabue, Guido, Guaraldi, Giovanni, Pezzuto, Giuseppe, Bechtold, Petra, Massari, Marco, Lattuada, Ivana, Luppi, Francesco, Galli, Maria Giulia, Pattacini, Pierpaolo, Giorgi Rossi, Paolo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9202871/
https://www.ncbi.nlm.nih.gov/pubmed/35709213
http://dx.doi.org/10.1371/journal.pone.0270111
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author Besutti, Giulia
Djuric, Olivera
Ottone, Marta
Monelli, Filippo
Lazzari, Patrizia
Ascari, Francesco
Ligabue, Guido
Guaraldi, Giovanni
Pezzuto, Giuseppe
Bechtold, Petra
Massari, Marco
Lattuada, Ivana
Luppi, Francesco
Galli, Maria Giulia
Pattacini, Pierpaolo
Giorgi Rossi, Paolo
author_facet Besutti, Giulia
Djuric, Olivera
Ottone, Marta
Monelli, Filippo
Lazzari, Patrizia
Ascari, Francesco
Ligabue, Guido
Guaraldi, Giovanni
Pezzuto, Giuseppe
Bechtold, Petra
Massari, Marco
Lattuada, Ivana
Luppi, Francesco
Galli, Maria Giulia
Pattacini, Pierpaolo
Giorgi Rossi, Paolo
author_sort Besutti, Giulia
collection PubMed
description BACKGROUND: COVID-19 prognostic factors include age, sex, comorbidities, laboratory and imaging findings, and time from symptom onset to seeking care. PURPOSE: The study aim was to evaluate indices combining disease severity measures and time from disease onset to predict mortality of COVID-19 patients admitted to the emergency department (ED). MATERIALS AND METHODS: All consecutive COVID-19 patients who underwent both computed tomography (CT) and chest X-ray (CXR) at ED presentation between 27/02/2020 and 13/03/2020 were included. CT visual score of disease extension and CXR Radiographic Assessment of Lung Edema (RALE) score were collected. The CT- and CXR-based scores, C-reactive protein (CRP), and oxygen saturation levels (sO(2)) were separately combined with time from symptom onset to ED presentation to obtain severity/time indices. Multivariable regression age- and sex-adjusted models without and with severity/time indices were compared. For CXR-RALE, the models were tested in a validation cohort. RESULTS: Of the 308 included patients, 55 (17.9%) died. In multivariable logistic age- and sex-adjusted models for death at 30 days, severity/time indices showed good discrimination ability, higher for imaging than for laboratory measures (AUC(CT) = 0.92, AUC(CXR) = 0.90, AUC(CRP) = 0.88, AUC(sO2) = 0.88). AUC(CXR) was lower in the validation cohort (0.79). The models including severity/time indices performed slightly better than models including measures of disease severity not combined with time and those including the Charlson Comorbidity Index, except for CRP-based models. CONCLUSION: Time from symptom onset to ED admission is a strong prognostic factor and provides added value to the interpretation of imaging and laboratory findings at ED presentation.
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spelling pubmed-92028712022-06-17 Imaging-based indices combining disease severity and time from disease onset to predict COVID-19 mortality: A cohort study Besutti, Giulia Djuric, Olivera Ottone, Marta Monelli, Filippo Lazzari, Patrizia Ascari, Francesco Ligabue, Guido Guaraldi, Giovanni Pezzuto, Giuseppe Bechtold, Petra Massari, Marco Lattuada, Ivana Luppi, Francesco Galli, Maria Giulia Pattacini, Pierpaolo Giorgi Rossi, Paolo PLoS One Research Article BACKGROUND: COVID-19 prognostic factors include age, sex, comorbidities, laboratory and imaging findings, and time from symptom onset to seeking care. PURPOSE: The study aim was to evaluate indices combining disease severity measures and time from disease onset to predict mortality of COVID-19 patients admitted to the emergency department (ED). MATERIALS AND METHODS: All consecutive COVID-19 patients who underwent both computed tomography (CT) and chest X-ray (CXR) at ED presentation between 27/02/2020 and 13/03/2020 were included. CT visual score of disease extension and CXR Radiographic Assessment of Lung Edema (RALE) score were collected. The CT- and CXR-based scores, C-reactive protein (CRP), and oxygen saturation levels (sO(2)) were separately combined with time from symptom onset to ED presentation to obtain severity/time indices. Multivariable regression age- and sex-adjusted models without and with severity/time indices were compared. For CXR-RALE, the models were tested in a validation cohort. RESULTS: Of the 308 included patients, 55 (17.9%) died. In multivariable logistic age- and sex-adjusted models for death at 30 days, severity/time indices showed good discrimination ability, higher for imaging than for laboratory measures (AUC(CT) = 0.92, AUC(CXR) = 0.90, AUC(CRP) = 0.88, AUC(sO2) = 0.88). AUC(CXR) was lower in the validation cohort (0.79). The models including severity/time indices performed slightly better than models including measures of disease severity not combined with time and those including the Charlson Comorbidity Index, except for CRP-based models. CONCLUSION: Time from symptom onset to ED admission is a strong prognostic factor and provides added value to the interpretation of imaging and laboratory findings at ED presentation. Public Library of Science 2022-06-16 /pmc/articles/PMC9202871/ /pubmed/35709213 http://dx.doi.org/10.1371/journal.pone.0270111 Text en © 2022 Besutti et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Besutti, Giulia
Djuric, Olivera
Ottone, Marta
Monelli, Filippo
Lazzari, Patrizia
Ascari, Francesco
Ligabue, Guido
Guaraldi, Giovanni
Pezzuto, Giuseppe
Bechtold, Petra
Massari, Marco
Lattuada, Ivana
Luppi, Francesco
Galli, Maria Giulia
Pattacini, Pierpaolo
Giorgi Rossi, Paolo
Imaging-based indices combining disease severity and time from disease onset to predict COVID-19 mortality: A cohort study
title Imaging-based indices combining disease severity and time from disease onset to predict COVID-19 mortality: A cohort study
title_full Imaging-based indices combining disease severity and time from disease onset to predict COVID-19 mortality: A cohort study
title_fullStr Imaging-based indices combining disease severity and time from disease onset to predict COVID-19 mortality: A cohort study
title_full_unstemmed Imaging-based indices combining disease severity and time from disease onset to predict COVID-19 mortality: A cohort study
title_short Imaging-based indices combining disease severity and time from disease onset to predict COVID-19 mortality: A cohort study
title_sort imaging-based indices combining disease severity and time from disease onset to predict covid-19 mortality: a cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9202871/
https://www.ncbi.nlm.nih.gov/pubmed/35709213
http://dx.doi.org/10.1371/journal.pone.0270111
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