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Quantitative Burden of COVID-19 Pneumonia on Chest CT Predicts Adverse Outcomes: A Post-Hoc Analysis of a Prospective International Registry.
Grodecki, Kajetan; Lin, Andrew; Cadet, Sebastien; McElhinney, Priscilla A; Razipour, Aryabod; Chan, Cato; Pressman, Barry; Julien, Peter; Maurovich-Horvat, Pal; Gaibazzi, Nicola; Thakur, Udit; Mancini, Elisabetta; Agalbato, Cecilia; Menè, Roberto; Parati, Gianfranco; Cernigliaro, Franco; Nerlekar, Nitesh; Torlasco, Camilla; Pontone, Gianluca; Slomka, Piotr J; Dey, Damini.
  • Grodecki K; Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA (K.G., A.L., P.A.M., A.R., D.D.); Monash Health, Melbourne, Australia (A.L., U.T., N.N.); Department of Imaging, Cedars-Sinai Medical Center (S.C., C.C., B.P., P.J.); Department of Radiology, Semmelweis Universi
  • Lin A; Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA (K.G., A.L., P.A.M., A.R., D.D.); Monash Health, Melbourne, Australia (A.L., U.T., N.N.); Department of Imaging, Cedars-Sinai Medical Center (S.C., C.C., B.P., P.J.); Department of Radiology, Semmelweis Universi
  • Cadet S; Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA (K.G., A.L., P.A.M., A.R., D.D.); Monash Health, Melbourne, Australia (A.L., U.T., N.N.); Department of Imaging, Cedars-Sinai Medical Center (S.C., C.C., B.P., P.J.); Department of Radiology, Semmelweis Universi
  • McElhinney PA; Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA (K.G., A.L., P.A.M., A.R., D.D.); Monash Health, Melbourne, Australia (A.L., U.T., N.N.); Department of Imaging, Cedars-Sinai Medical Center (S.C., C.C., B.P., P.J.); Department of Radiology, Semmelweis Universi
  • Razipour A; Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA (K.G., A.L., P.A.M., A.R., D.D.); Monash Health, Melbourne, Australia (A.L., U.T., N.N.); Department of Imaging, Cedars-Sinai Medical Center (S.C., C.C., B.P., P.J.); Department of Radiology, Semmelweis Universi
  • Chan C; Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA (K.G., A.L., P.A.M., A.R., D.D.); Monash Health, Melbourne, Australia (A.L., U.T., N.N.); Department of Imaging, Cedars-Sinai Medical Center (S.C., C.C., B.P., P.J.); Department of Radiology, Semmelweis Universi
  • Pressman B; Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA (K.G., A.L., P.A.M., A.R., D.D.); Monash Health, Melbourne, Australia (A.L., U.T., N.N.); Department of Imaging, Cedars-Sinai Medical Center (S.C., C.C., B.P., P.J.); Department of Radiology, Semmelweis Universi
  • Julien P; Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA (K.G., A.L., P.A.M., A.R., D.D.); Monash Health, Melbourne, Australia (A.L., U.T., N.N.); Department of Imaging, Cedars-Sinai Medical Center (S.C., C.C., B.P., P.J.); Department of Radiology, Semmelweis Universi
  • Maurovich-Horvat P; Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA (K.G., A.L., P.A.M., A.R., D.D.); Monash Health, Melbourne, Australia (A.L., U.T., N.N.); Department of Imaging, Cedars-Sinai Medical Center (S.C., C.C., B.P., P.J.); Department of Radiology, Semmelweis Universi
  • Gaibazzi N; Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA (K.G., A.L., P.A.M., A.R., D.D.); Monash Health, Melbourne, Australia (A.L., U.T., N.N.); Department of Imaging, Cedars-Sinai Medical Center (S.C., C.C., B.P., P.J.); Department of Radiology, Semmelweis Universi
  • Thakur U; Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA (K.G., A.L., P.A.M., A.R., D.D.); Monash Health, Melbourne, Australia (A.L., U.T., N.N.); Department of Imaging, Cedars-Sinai Medical Center (S.C., C.C., B.P., P.J.); Department of Radiology, Semmelweis Universi
  • Mancini E; Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA (K.G., A.L., P.A.M., A.R., D.D.); Monash Health, Melbourne, Australia (A.L., U.T., N.N.); Department of Imaging, Cedars-Sinai Medical Center (S.C., C.C., B.P., P.J.); Department of Radiology, Semmelweis Universi
  • Agalbato C; Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA (K.G., A.L., P.A.M., A.R., D.D.); Monash Health, Melbourne, Australia (A.L., U.T., N.N.); Department of Imaging, Cedars-Sinai Medical Center (S.C., C.C., B.P., P.J.); Department of Radiology, Semmelweis Universi
  • Menè R; Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA (K.G., A.L., P.A.M., A.R., D.D.); Monash Health, Melbourne, Australia (A.L., U.T., N.N.); Department of Imaging, Cedars-Sinai Medical Center (S.C., C.C., B.P., P.J.); Department of Radiology, Semmelweis Universi
  • Parati G; Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA (K.G., A.L., P.A.M., A.R., D.D.); Monash Health, Melbourne, Australia (A.L., U.T., N.N.); Department of Imaging, Cedars-Sinai Medical Center (S.C., C.C., B.P., P.J.); Department of Radiology, Semmelweis Universi
  • Cernigliaro F; Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA (K.G., A.L., P.A.M., A.R., D.D.); Monash Health, Melbourne, Australia (A.L., U.T., N.N.); Department of Imaging, Cedars-Sinai Medical Center (S.C., C.C., B.P., P.J.); Department of Radiology, Semmelweis Universi
  • Nerlekar N; Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA (K.G., A.L., P.A.M., A.R., D.D.); Monash Health, Melbourne, Australia (A.L., U.T., N.N.); Department of Imaging, Cedars-Sinai Medical Center (S.C., C.C., B.P., P.J.); Department of Radiology, Semmelweis Universi
  • Torlasco C; Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA (K.G., A.L., P.A.M., A.R., D.D.); Monash Health, Melbourne, Australia (A.L., U.T., N.N.); Department of Imaging, Cedars-Sinai Medical Center (S.C., C.C., B.P., P.J.); Department of Radiology, Semmelweis Universi
  • Pontone G; Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA (K.G., A.L., P.A.M., A.R., D.D.); Monash Health, Melbourne, Australia (A.L., U.T., N.N.); Department of Imaging, Cedars-Sinai Medical Center (S.C., C.C., B.P., P.J.); Department of Radiology, Semmelweis Universi
  • Slomka PJ; Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA (K.G., A.L., P.A.M., A.R., D.D.); Monash Health, Melbourne, Australia (A.L., U.T., N.N.); Department of Imaging, Cedars-Sinai Medical Center (S.C., C.C., B.P., P.J.); Department of Radiology, Semmelweis Universi
  • Dey D; Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA (K.G., A.L., P.A.M., A.R., D.D.); Monash Health, Melbourne, Australia (A.L., U.T., N.N.); Department of Imaging, Cedars-Sinai Medical Center (S.C., C.C., B.P., P.J.); Department of Radiology, Semmelweis Universi
Radiol Cardiothorac Imaging ; 2(5): e200389, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-1156005
ABSTRACT

PURPOSE:

To examine the independent and incremental value of CT-derived quantitative burden and attenuation of COVID-19 pneumonia for the prediction of clinical deterioration or death.

METHODS:

This was a retrospective analysis of a prospective international registry of consecutive patients with laboratory-confirmed COVID-19 and chest CT imaging, admitted to four centers between January 10 and May 6, 2020. Total burden (expressed as a percentage) and mean attenuation of ground glass opacities (GGO) and consolidation were quantified from CT using semi-automated research software. The primary outcome was clinical deterioration (intensive care unit admission, invasive mechanical ventilation, or vasopressor therapy) or in-hospital death. Logistic regression was performed to assess the predictive value of clinical and CT parameters for the primary outcome.

RESULTS:

The final population comprised 120 patients (mean age 64 ± 16 years, 78 men), of whom 39 (32.5%) experienced clinical deterioration or death. In multivariable regression of clinical and CT parameters, consolidation burden (odds ratio [OR], 3.4; 95% confidence interval [CI] 1.7, 6.9 per doubling; P = .001) and increasing GGO attenuation (OR, 3.2; 95% CI 1.3, 8.3 per standard deviation, P = .02) were independent predictors of deterioration or death; as was C-reactive protein (OR, 2.1; 95% CI 1.3, 3.4 per doubling; P = .004), history of heart failure (OR 1.3; 95% CI 1.1, 1.6, P = .01), and chronic lung disease (OR, 1.3; 95% CI 1.0, 1.6; P = .02). Quantitative CT measures added incremental predictive value beyond a model with only clinical parameters (area under the curve, 0.93 vs 0.82, P = .006). The optimal prognostic cutoffs for burden of COVID-19 pneumonia as determined by Youden's index were consolidation of greater than or equal to 1.8% and GGO of greater than or equal to 13.5%.

CONCLUSIONS:

Quantitative burden of consolidation or GGO on chest CT independently predict clinical deterioration or death in patients with COVID-19 pneumonia. CT-derived measures have incremental prognostic value over and above clinical parameters, and may be useful for risk stratifying patients with COVID-19.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study Language: English Journal: Radiol Cardiothorac Imaging Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study Language: English Journal: Radiol Cardiothorac Imaging Year: 2020 Document Type: Article