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Chest CT score in COVID-19 patients: correlation with disease severity and short-term prognosis

Francone, Marco ; Iafrate, Franco ; Masci, Giorgio Maria ; Coco, Simona ; Cilia, Francesco ; Manganaro, Lucia ; Panebianco, Valeria ; Andreoli, Chiara ; Colaiacomo, Maria Chiara ; Zingaropoli, Maria Antonella ; Ciardi, Maria Rosa ; Mastroianni, Claudio Maria ; Pugliese, Francesco ; Alessandri, Francesco ; Turriziani, Ombretta ; Ricci, Paolo ; Catalano, Carlo

European radiology, 2020-12, Vol.30 (12), p.6808-6817 [Periódico revisado por pares]

Berlin/Heidelberg: Springer Berlin Heidelberg

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Título:
Chest CT score in COVID-19 patients: correlation with disease severity and short-term prognosis
Autor: Francone, Marco ; Iafrate, Franco ; Masci, Giorgio Maria ; Coco, Simona ; Cilia, Francesco ; Manganaro, Lucia ; Panebianco, Valeria ; Andreoli, Chiara ; Colaiacomo, Maria Chiara ; Zingaropoli, Maria Antonella ; Ciardi, Maria Rosa ; Mastroianni, Claudio Maria ; Pugliese, Francesco ; Alessandri, Francesco ; Turriziani, Ombretta ; Ricci, Paolo ; Catalano, Carlo
Assuntos: Adult ; Betacoronavirus ; Biomarkers ; Chest ; Coronavirus Infections - diagnosis ; Coronavirus Infections - epidemiology ; Coronaviruses ; Correlation analysis ; COVID-19 ; Diagnostic Radiology ; Diagnostic systems ; Dimers ; Evaluation ; Female ; Fibrosis ; Humans ; Imaging ; Inflammation ; Internal Medicine ; Interventional Radiology ; Italy - epidemiology ; Laboratories ; Lung - diagnostic imaging ; Male ; Medical prognosis ; Medicine ; Medicine & Public Health ; Middle Aged ; Mortality ; Mortality risk ; Multivariate analysis ; Neuroradiology ; Pandemics ; Pneumonia, Viral - diagnosis ; Pneumonia, Viral - epidemiology ; Prognosis ; Radiology ; Retrospective Studies ; SARS-CoV-2 ; Severe acute respiratory syndrome ; Severe acute respiratory syndrome coronavirus 2 ; Severity of Illness Index ; Signs and symptoms ; Tomography, X-Ray Computed - methods ; Ultrasound ; Viral diseases ; Workflow
É parte de: European radiology, 2020-12, Vol.30 (12), p.6808-6817
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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Descrição: Objectives To correlate a CT-based semi-quantitative score of pulmonary involvement in COVID-19 pneumonia with clinical staging of disease and laboratory findings. We also aimed to investigate whether CT findings may be predictive of patients’ outcome. Methods From March 6 to March 22, 2020, 130 symptomatic SARS-CoV-2 patients were enrolled for this single-center analysis and chest CT examinations were retrospectively evaluated. A semi-quantitative CT score was calculated based on the extent of lobar involvement (0:0%; 1, < 5%; 2:5–25%; 3:26–50%; 4:51–75%; 5, > 75%; range 0–5; global score 0–25). Data were matched with clinical stages and laboratory findings. Survival curves and univariate and multivariate analyses were performed to evaluate the role of CT score as a predictor of patients’ outcome. Results Ground glass opacities were predominant in early-phase (≤ 7 days since symptoms’ onset), while crazy-paving pattern, consolidation, and fibrosis characterized late-phase disease (> 7 days). CT score was significantly higher in critical and severe than in mild stage ( p < 0.0001), and among late-phase than early-phase patients ( p < 0.0001). CT score was significantly correlated with CRP ( p < 0.0001, r = 0.6204) and D-dimer ( p < 0.0001, r = 0.6625) levels. A CT score of ≥ 18 was associated with an increased mortality risk and was found to be predictive of death both in univariate (HR, 8.33; 95% CI, 3.19–21.73; p < 0.0001) and multivariate analysis (HR, 3.74; 95% CI, 1.10–12.77; p = 0.0348). Conclusions Our preliminary data suggest the potential role of CT score for predicting the outcome of SARS-CoV-2 patients. CT score is highly correlated with laboratory findings and disease severity and might be beneficial to speed-up diagnostic workflow in symptomatic cases. Key Points • CT score is positively correlated with age, inflammatory biomarkers, severity of clinical categories, and disease phases. • A CT score ≥ 18 has shown to be highly predictive of patient’s mortality in short-term follow-up. • Our multivariate analysis demonstrated that CT parenchymal assessment may more accurately reflect short-term outcome, providing a direct visualization of anatomic injury compared with non-specific inflammatory biomarkers.
Editor: Berlin/Heidelberg: Springer Berlin Heidelberg
Idioma: Inglês

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Chest CT score in COVID-19 patients: correlation with disease severity and short-term prognosis

Berlin/Heidelberg: Springer Berlin Heidelberg

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