Your browser doesn't support javascript.
Chest CT score in COVID-19 patients: correlation with disease severity and short-term prognosis.
Francone, Marco; Iafrate, Franco; Masci, Giorgio Maria; Coco, Simona; Cilia, Francesco; Manganaro, Lucia; Panebianco, Valeria; Andreoli, Chiara; Colaiacomo, Maria Chiara; Zingaropoli, Maria Antonella; Ciardi, Maria Rosa; Mastroianni, Claudio Maria; Pugliese, Francesco; Alessandri, Francesco; Turriziani, Ombretta; Ricci, Paolo; Catalano, Carlo.
  • Francone M; Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
  • Iafrate F; Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy. francoiafrate@gmail.com.
  • Masci GM; Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
  • Coco S; Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
  • Cilia F; Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
  • Manganaro L; Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
  • Panebianco V; Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
  • Andreoli C; Unit of Emergency Radiology, Policlinico Umberto I, Policlinico Umberto I, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
  • Colaiacomo MC; Unit of Emergency Radiology, Policlinico Umberto I, Policlinico Umberto I, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
  • Zingaropoli MA; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy.
  • Ciardi MR; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy.
  • Mastroianni CM; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy.
  • Pugliese F; Department of Anaesthesiology Critical Care Medicine and Pain Therapy, Policlinico Umberto I, Sapienza University, Viale Regina Elena 324, 00161, Rome, Italy.
  • Alessandri F; Department of Anaesthesiology Critical Care Medicine and Pain Therapy, Policlinico Umberto I, Sapienza University, Viale Regina Elena 324, 00161, Rome, Italy.
  • Turriziani O; Department of Molecular Medicine, Sapienza University of Rome, Viale dell'Università 31, 00185, Rome, Italy.
  • Ricci P; Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
  • Catalano C; Unit of Emergency Radiology, Policlinico Umberto I, Policlinico Umberto I, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
Eur Radiol ; 30(12): 6808-6817, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-629489
ABSTRACT

OBJECTIVES:

To correlate a CT-based semi-quantitative score of pulmonary involvement in COVID-19 pneumonia with clinical staging of disease and laboratory findings. We also aimed to investigate whether CT findings may be predictive of patients' outcome.

METHODS:

From March 6 to March 22, 2020, 130 symptomatic SARS-CoV-2 patients were enrolled for this single-center analysis and chest CT examinations were retrospectively evaluated. A semi-quantitative CT score was calculated based on the extent of lobar involvement (00%; 1, < 5%; 25-25%; 326-50%; 451-75%; 5, > 75%; range 0-5; global score 0-25). Data were matched with clinical stages and laboratory findings. Survival curves and univariate and multivariate analyses were performed to evaluate the role of CT score as a predictor of patients' outcome.

RESULTS:

Ground glass opacities were predominant in early-phase (≤ 7 days since symptoms' onset), while crazy-paving pattern, consolidation, and fibrosis characterized late-phase disease (> 7 days). CT score was significantly higher in critical and severe than in mild stage (p < 0.0001), and among late-phase than early-phase patients (p < 0.0001). CT score was significantly correlated with CRP (p < 0.0001, r = 0.6204) and D-dimer (p < 0.0001, r = 0.6625) levels. A CT score of ≥ 18 was associated with an increased mortality risk and was found to be predictive of death both in univariate (HR, 8.33; 95% CI, 3.19-21.73; p < 0.0001) and multivariate analysis (HR, 3.74; 95% CI, 1.10-12.77; p = 0.0348).

CONCLUSIONS:

Our preliminary data suggest the potential role of CT score for predicting the outcome of SARS-CoV-2 patients. CT score is highly correlated with laboratory findings and disease severity and might be beneficial to speed-up diagnostic workflow in symptomatic cases. KEY POINTS • CT score is positively correlated with age, inflammatory biomarkers, severity of clinical categories, and disease phases. • A CT score ≥ 18 has shown to be highly predictive of patient's mortality in short-term follow-up. • Our multivariate analysis demonstrated that CT parenchymal assessment may more accurately reflect short-term outcome, providing a direct visualization of anatomic injury compared with non-specific inflammatory biomarkers.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Tomography, X-Ray Computed / Coronavirus Infections / Pandemics / Betacoronavirus / Lung Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Eur Radiol Journal subject: Radiology Year: 2020 Document Type: Article Affiliation country: S00330-020-07033-y

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Tomography, X-Ray Computed / Coronavirus Infections / Pandemics / Betacoronavirus / Lung Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Eur Radiol Journal subject: Radiology Year: 2020 Document Type: Article Affiliation country: S00330-020-07033-y