Pulmonary artery trunk enlargement on admission as a predictor of mortality in in-hospital patients with COVID-19.

PURPOSE: To describe the prognostic value of pulmonary artery (PA) trunk enlargement on the admission of in-hospital patients with severe COVID-19 infection by unenhanced CT image. MATERIALS AND METHODS: In-hospital patients confirmed COVID-19 from January 18, 2020, to March 7, 2020, were retrospectively enrolled. PA trunk diameters on admission and death events were collected to calculate the optimum cutoff using a receiver operating characteristic curve. According to the cutoff, the subjects on admission were divided into two groups. Then the in-hospital various parameters were compared between the two groups to assess the predictive value of PA trunk diameter. RESULTS: In the 180 enrolled in-hospital patients (46.99 ± 14.95 years; 93 (51.7%) female, 14 patients (7.8%) died during their hospitalization. The optimum cutoff PA trunk diameter to predict in-hospital mortality was > 29 mm with a sensitivity of 92.59% and a specificity of 91.11%. Kaplan-Meier survival curves for PA trunk diameter on admission showed that a PA trunk diameter > 29 mm was a significant predictor of subsequent death (log-rank < 0.001, median survival time of PA > 29 mm was 28 days). CONCLUSION: PA trunk enlargement can be a useful predictive factor for distinguishing between mild and severe COVID-19 disease progression.

Differences and prediction of imaging characteristics of COVID-19 and non-COVID-19 viral pneumonia: A multicenter study.

To study the differences in imaging characteristics and prediction of COVID-19 and non-COVID-19 viral pneumonia through chest CT.Chest CT data of 128 cases of COVID-19 and 47 cases of non-COVID-19 viral pneumonia confirmed by several hospitals were retrospectively collected, the imaging performance was evaluated and recorded, different imaging features were statistically analyzed, and a prediction model and independent predicted imaging features were obtained by multivariable analysis.COVID-19 was more likely than non-COVID-19 pneumonia to have a high-grade ground glass opacities (P = .01), extensive lesion distribution (P < .001), mixed lesions of varying sizes (27.7% vs 57.0%, P = .001), subpleural prominence (23.4% vs 86.7%, P < .001), and lower lobe prominence (48.9% vs 82.0%, P < .001). However, peribronchial interstitial thickening was more likely to occur in non-COVID-19 viral pneumonia (36.2% vs 19.5%, P = .022). The statistically significant differences from multivariable analysis were the degree of ground glass opacities (P = .001), lesion distribution (P = .045), lesion size (P = .020), subpleural prominence (P < .001), and lower lobe prominence (P = .041). The sensitivity and specificity of the model were 94.5% and 76.6%, respectively, with an AUC of 0.91.The imaging characteristics of COVID-19 and non-COVID-19 viral pneumonia are different, and the prediction model can further improve the specificity of chest CT diagnosis.

Timely Diagnosis and Treatment Shortens the Time to Resolution of Coronavirus Disease (COVID-19) Pneumonia and Lowers the Highest and Last CT Scores From Sequential Chest CT.

OBJECTIVE. This study aims to assess correlations of the time from symptom onset to diagnosis and treatment with the time to disease resolution and CT scores as based on findings from sequential chest CT examinations. MATERIALS AND METHODS. Thirty patients with coronavirus disease (COVID-19) confirmed by reverse transcription-polymerase chain reaction analysis underwent chest CT examinations. Five patients who did not have positive CT findings or who had not yet fulfilled criteria for discharge from the hospital were excluded. CT scores were determined according to CT findings and lung involvement. The time from symptom onset to diagnosis and treatment was recorded for each patient, and on the basis of this information, patients with COVID-19 were divided into group 1 (patients for whom this interval was ≤ 3 days) and group 2 (those for whom this interval was > 3 days). The CT scores for each group were fitted using a Lorentzian line-shape curve to show the variation tendency during treatment. The differences in age, sex, and last CT scores determined before discharge between the two groups were analyzed, and correlations of the time from symptom onset to diagnosis and treatment with the time to disease resolution as well as with the highest CT score also underwent statistical analysis. RESULTS. A total of 25 subjects were enrolled in the study. The fitted tendency curves for group 1 and group 2 were significantly different, with peak points showing that the estimated highest CT score was 10 and 16 for each group, respectively, and the time to disease resolution was 6 and 13 days, respectively. The Mann-Whitney test showed that the last CT scores were lower for group 1 than for group 2 (p = 0.025), although the chi-square test found no difference in age and sex between the groups. The time from symptom onset to diagnosis and treatment had a positive correlation with the time to disease resolution (r = 0.93; p = 0.000) as well as with the highest CT score (r = 0.83; p = 0.006). CONCLUSION. Timely diagnosis and treatment are key to providing a better prognosis for patients with COVID-19.