ABSTRACT
Background@#The novel coronavirus disease 2019 (COVID-19) continues to wreak havoc worldwide. This study assessed the ability of chest computed tomography (CT) severity score (CSS) to predict intensive care unit (ICU) admission and mortality in patients with COVID-19 pneumonia. @*Materials and Methods@#A total of 192 consecutive patients with COVID-19 pneumonia aged more than 20 years and typical CT findings and reverse-transcription polymerase chain reaction positive admitted in a tertiary hospital were included. Clinical symptoms at admission and short-term outcome were obtained. A semi-quantitative scoring system was used to evaluate the parenchymal involvement. The association between CSS, disease severity, and outcomes were evaluated. Prediction of CSS was assessed with the area under the receiver-operating characteristic (ROC) curves. @*Results@#The incidence of admission to ICU was 22.8% in men and 14.1% in women. CSS was related to ICU admission and mortality. Areas under the ROC curves were 0.764 for total CSS.Using a stepwise binary logistic regression model, gender, age, oxygen saturation, and CSS had a significant independent relationship with ICU admission and death. Patients with CSS ≥12.5 had about four-time risk of ICU admission and death (odds ratio 1.66, 95% confidence interval 1.66 – 9.25). The multivariate regression analysis showed the superiority of CSS over other clinical information and co-morbidities. @*Conclusion@#CSS was a strong predictor of progression to ICU admission and death and there was a substantial role of non-contrast chest CT imaging in the presence of typical features for COVID-19 pneumonia as a reliable predictor of clinical severity and patient’s outcome.
ABSTRACT
Background@#The novel coronavirus disease 2019 (COVID-19) continues to wreak havoc worldwide. This study assessed the ability of chest computed tomography (CT) severity score (CSS) to predict intensive care unit (ICU) admission and mortality in patients with COVID-19 pneumonia. @*Materials and Methods@#A total of 192 consecutive patients with COVID-19 pneumonia aged more than 20 years and typical CT findings and reverse-transcription polymerase chain reaction positive admitted in a tertiary hospital were included. Clinical symptoms at admission and short-term outcome were obtained. A semi-quantitative scoring system was used to evaluate the parenchymal involvement. The association between CSS, disease severity, and outcomes were evaluated. Prediction of CSS was assessed with the area under the receiver-operating characteristic (ROC) curves. @*Results@#The incidence of admission to ICU was 22.8% in men and 14.1% in women. CSS was related to ICU admission and mortality. Areas under the ROC curves were 0.764 for total CSS.Using a stepwise binary logistic regression model, gender, age, oxygen saturation, and CSS had a significant independent relationship with ICU admission and death. Patients with CSS ≥12.5 had about four-time risk of ICU admission and death (odds ratio 1.66, 95% confidence interval 1.66 – 9.25). The multivariate regression analysis showed the superiority of CSS over other clinical information and co-morbidities. @*Conclusion@#CSS was a strong predictor of progression to ICU admission and death and there was a substantial role of non-contrast chest CT imaging in the presence of typical features for COVID-19 pneumonia as a reliable predictor of clinical severity and patient’s outcome.
ABSTRACT
Objectives@#Bone mineral density (BMD), as a gold standard determinant of osteoporosis, assesses only one of many characteristics contributing to the bone. Trabecular bone score (TBS) is applied to evaluate the microarchitecture of trabecular bone. A high body mass index (BMI) has been reported to have a positive correlation with BMD. However, the relation between BMI and TBS has remained unclear.Therefore, the aim of this study is to shed light on the associations between BMI, T-score, and TBS in postmenopausal women without a diagnosed underlying disease. @*Methods@#In this cross-sectional study, 1054 postmenopausal women were randomly recruited from the Department of Radiology, Isfahan University of Medical Sciences. Demographic characteristics and medical history of all subjects were collected from documents. TBS measurements for L1-L4 vertebrae were retrospectively performed by the TBS iNsight software using the dual X-ray absorptiometry (DXA) from the same region of spine of the subjects. The analysis was done to detect the correlation between TBS and BMI. @*Results@#A statistically significant negative correlation was found between TBS and BMI in patients with osteoporosis and low bone mass. In patients with normal T-scores, BMI was not significantly correlated to TBS (P > 0.05). Furthermore, there was a significant positive association between T-score and BMI. @*Conclusions@#Although a higher BMI had a protective effect against osteoporosis, higher BMI was associated with a lower TBS in patients with an abnormal T-score. However, BMI did not have a significant effect on TBS in patients with normal T-scores.