Prognostic Value of Chest-Computed Tomography in Patients with COVID-19.

BACKGROUND: The diagnostic value for chest CT has been widely established in patients with COVID-19. However, there is a lack of satisfactory data about the prognostic value of chest CTs. This study investigated the prognostic value of chest CTs in COVID-19 patients. MATERIALS AND METHODS: A total of 521 symptomatic patients hospitalized with COVID-19 were included retrospectively. Clinical, laboratory, and chest CT characteristics were compared between survivors and non-survivors. Concerning chest CT, for each subject, a semi-quantitative CT severity scoring system was applied. RESULTS: Most patients showed typical CT features based on the likelihood of COVID-19. The global CT score was significantly higher in non-survivors (median (IQR), 1 (0-6) vs. 10 (5-13), p < 0.001). A cut-off value of 5.5 for the global CT score predicted in-hospital mortality with 74% sensitivity and 73% specificity. Global CT score, age, C-reactive protein, and diabetes were independent predictors of in-hospital mortality. The global CT score was significantly correlated with the C-reactive protein, D-dimer, pro-brain natriuretic peptide, and procalcitonin levels. CONCLUSION: The global CT score could provide valuable prognostic data in symptomatic patients with COVID-19.

Assessment of COVID-19 deaths from cardiological perspective.

BACKGROUND: COVID-19 can cause a variety of cardiac complications and a range of electrocardiographic abnormalities. We analysed cardiological parameters including ECG and high-sensitivity troponin T (hs-TnT) level and their association with mortality in hospitalised patients with COVID-19. METHODS: We retrospectively analysed the demographics, comorbidities, laboratory findings and electrocardiographic parameters of 453 consecutive patients, whose outcome was clear, died or discharged. Findings were compared between survivors and non-survivors. Also, the same comparison was made between cardiac injury and no-cardiac injury subgroups. RESULTS: The cardiac injury group had significantly higher in-hospital mortality than the no-cardiac injury group. Also, frequencies of atrial fibrillation, axis change, ST-segment/T-wave change, fragmented QRS, premature atrial/ventricular contraction was found to be higher in the cardiac injury group. Moreover, non-survivors had longer QRS intervals, more frequent ST-segment/T-wave changes and isolated S1Q3T3 pattern than surviving patients. Laboratory results showed median values of hs-TnT at the admission of 4.95 ng/L (IQR, 3-12.35) with concentrations markedly higher in the non-surviving patients vs survivors. Hs-TnT value along with age and respiratory rate was found to be an independent predictor of in-hospital mortality in hospitalised patients with COVID-19. Comorbidities were more frequently reported in non-surviving and cardiac injury groups than those surviving and without cardiac injury. CONCLUSIONS: In COVID-19 patients, both elevated hs-TnT and ECG abnormalities, suggesting cardiac involvement, on admission portends an ominous prognosis and indicates at higher risk of in-hospital mortality. Prioritised treatment and more aggressive therapeutic strategies could be planned to avoid the occurrence of death in these patients.