Chest CT scan lesions as predictors of poor prognosis in critically ill COVID-19 patients

ABSTRACT

Chest CT scan lesions as predictors of poor prognosis in critically ill COVID-19 patients Background: Chest computed tomography (CT) scan was suggested to be an early tool for the diagnosis of COVID19 pneumonia. However, little is known about the role of chest CT-scan to predict outcomes in patients admitted in intensive care unit (ICU) for COVID-19 pneumonia. Aim(s) To determine the association between the extent of chest CT scan lesions and poor outcomes in critically ill COVID-19 patients. Method(s) A retrospective observational study performed in a 9-bed ICU from 1rst January 2021 to December 31, 2021 including adult admitted for COVID-19 pneumonia who underwent a chest CT scan. Patients' charaterisics, chest CT findings, management and outcomes were collected. Result(s) During the study period, 146 patients underwent a chest CT scan. Patients' characteristics were mean age 50.62+/-14.95years, median SAPSII, 24[16-31];median SOFA, 3[2-4] and median PaO2/FiO2 ratio 92[69-123]. High flow nasal cannula was performed in 128(87.7%) and 12(8.2%) patients required invasive mechanical ventilation (IMV) at admission. Median ICU length of stay was 8[5-14] days, mortality rate was at 55(37.7%) and the 4C mortality score was 1[0-1]. Severe lesions were identified in 89(61%) patients. Prolonged ICU stay was significantly more common in patients with severe lesions (p=0.02). However, mortality rate and IMV use (p=0.746) did not differ between mild to moderate lesion group and severe lesion group (p=0.869). Conclusion(s) Prolonged ICU stay was significantly associated with severe chest CT scan lesions and interestingly, mortality did not differ between severe lesions and mild to moderate lesions.