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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...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2022
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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. |
format | Online Article Text |
id | pubmed-9202871 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
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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