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Clinical and Chest Radiography Features Determine Patient Outcomes in Young and Middle-aged Adults with COVID-19.
Toussie, Danielle; Voutsinas, Nicholas; Finkelstein, Mark; Cedillo, Mario A; Manna, Sayan; Maron, Samuel Z; Jacobi, Adam; Chung, Michael; Bernheim, Adam; Eber, Corey; Concepcion, Jose; Fayad, Zahi A; Gupta, Yogesh Sean.
  • Toussie D; From the Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, 1468 Madison Ave, New York, NY 10029.
  • Voutsinas N; From the Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, 1468 Madison Ave, New York, NY 10029.
  • Finkelstein M; From the Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, 1468 Madison Ave, New York, NY 10029.
  • Cedillo MA; From the Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, 1468 Madison Ave, New York, NY 10029.
  • Manna S; From the Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, 1468 Madison Ave, New York, NY 10029.
  • Maron SZ; From the Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, 1468 Madison Ave, New York, NY 10029.
  • Jacobi A; From the Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, 1468 Madison Ave, New York, NY 10029.
  • Chung M; From the Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, 1468 Madison Ave, New York, NY 10029.
  • Bernheim A; From the Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, 1468 Madison Ave, New York, NY 10029.
  • Eber C; From the Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, 1468 Madison Ave, New York, NY 10029.
  • Concepcion J; From the Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, 1468 Madison Ave, New York, NY 10029.
  • Fayad ZA; From the Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, 1468 Madison Ave, New York, NY 10029.
  • Gupta YS; From the Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, 1468 Madison Ave, New York, NY 10029.
Radiology ; 297(1): E197-E206, 2020 10.
Artículo en Inglés | MEDLINE | ID: covidwho-817842
ABSTRACT
Background Chest radiography has not been validated for its prognostic utility in evaluating patients with coronavirus disease 2019 (COVID-19). Purpose To analyze the prognostic value of a chest radiograph severity scoring system for younger (nonelderly) patients with COVID-19 at initial presentation to the emergency department (ED); outcomes of interest included hospitalization, intubation, prolonged stay, sepsis, and death. Materials and Methods In this retrospective study, patients between the ages of 21 and 50 years who presented to the ED of an urban multicenter health system from March 10 to March 26, 2020, with COVID-19 confirmation on real-time reverse transcriptase polymerase chain reaction were identified. Each patient's ED chest radiograph was divided into six zones and examined for opacities by two cardiothoracic radiologists, and scores were collated into a total concordant lung zone severity score. Clinical and laboratory variables were collected. Multivariable logistic regression was used to evaluate the relationship between clinical parameters, chest radiograph scores, and patient outcomes. Results The study included 338 patients 210 men (62%), with median age of 39 years (interquartile range, 31-45 years). After adjustment for demographics and comorbidities, independent predictors of hospital admission (n = 145, 43%) were chest radiograph severity score of 2 or more (odds ratio, 6.2; 95% confidence interval [CI] 3.5, 11; P < .001) and obesity (odds ratio, 2.4 [95% CI 1.1, 5.4] or morbid obesity). Among patients who were admitted, a chest radiograph score of 3 or more was an independent predictor of intubation (n = 28) (odds ratio, 4.7; 95% CI 1.8, 13; P = .002) as was hospital site. No significant difference was found in primary outcomes across race and ethnicity or those with a history of tobacco use, asthma, or diabetes mellitus type II. Conclusion For patients aged 21-50 years with coronavirus disease 2019 presenting to the emergency department, a chest radiograph severity score was predictive of risk for hospital admission and intubation. © RSNA, 2020 Online supplemental material is available for this article.
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Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Asunto principal: Neumonía Viral / Infecciones por Coronavirus / Pandemias / Pulmón Tipo de estudio: Estudios diagnósticos / Estudio experimental / Estudio observacional / Estudio pronóstico Límite: Adulto / Femenino / Humanos / Masculino / Middle aged / Young_adult Idioma: Inglés Revista: Radiology Año: 2020 Tipo del documento: Artículo

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Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Asunto principal: Neumonía Viral / Infecciones por Coronavirus / Pandemias / Pulmón Tipo de estudio: Estudios diagnósticos / Estudio experimental / Estudio observacional / Estudio pronóstico Límite: Adulto / Femenino / Humanos / Masculino / Middle aged / Young_adult Idioma: Inglés Revista: Radiology Año: 2020 Tipo del documento: Artículo