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Cardiopulmonary imaging utilization and findings among hospitalized COVID-19 patients in Latin America (From RIMAC: Registry IMAging Cardiopulmonary among hospitalized COVID-19 patients in LATAM)

Salvador Vicente Spina; Marcelo Luiz Campos Vieira; Cesar Herrera; Ana Munera Echeverri; Pamela Rojo; Alma Sthela Arrioja Salazar; Zuilma Vazquez Ortiz; Roberto Baltodano; Graciela Reyes; Rocio Aceves Millan; Juan Calderon Gonzalez; Ana Camarozano; Edgar Aviles; Marco Antonio Cabrera; Maria Florencia Grande Ratti; Jorge Lowenstein; Rodrigo Hernandez Vyhmeister; Pamela Pina Santana; Jaime Ibarra Burgos; Alejandra Rivera; Beatriz Fernandez Campos; Kelly Cupe Chacalcaje; Mariela De Santos; Tania Regina Afonso; Tomas Miranda Aquino; Ana Lalyre Acosta; Beatriz Dominguez; Federico Campos; Sergio Alday Ramirez; Angela Cachicatari Beltran; Daniela Alvarez; Patricia Oliveira Roveri; Carlos Rosales Ixcamparij; Ender Otoniel Gonzalez; Pedro Vargas; Maximiliano Flores Flamand; Rosa Lopez Martinez; Luciana Meza; Samira Saady Morthy; Rudy Ovalle; Stalin Martinez; Oscar Perez Orpinel; Mauricio Potito; Otto Orellana; Jorge Marte Baez; Consuelo Orihuela Sandoval; Marcos Granillo Fernandez; Rohit Loomba; Saul Flores; Jose Maria Hernandez Hernandez; Ricardo Pignatelli.
Preprint en Inglés | PREPRINT-MEDRXIV | ID: ppmedrxiv-22269002
ObjectivesTo describe the use and findings of cardiopulmonary imaging - chest X-ray (cX-ray), echocardiography (cEcho), chest CT (cCT), lung ultrasound (LUS)) and/or cardiac magnetic resonance imaging (cMRI) - in COVID-19-associated hospitalizations in Latin America (LATAM) BackgroundThe SARS-Cov-2 is one of the largest and most active threats to healthcare in living memory. There is an information gap on imaging services resources (ISR) used and their findings during the pandemic in LATAM. MethodsThis was a multicenter, prospective, observational study of COVID-19 inpatients conducted from March to December 2020 from 12 high-complexity centers in nine LATAM countries. Adults (> 18 yrs) with at least one imaging modality performed, followed from admission until discharge and/or in-hospital death, were included. ResultsWe studied 1435 hospitalized patients (64% males) with a median age of 58 years classified into three regions 262 from Mexico (Mx), 428 from Central America and Caribbean (CAC), and 745 from South America (SAm). More frequent comorbidities were overweight/obesity (61%), hypertension (45%), and diabetes (27%). During hospitalization, 58% were admitted to ICU. The in-hospital mortality was 28% (95%CI 25-30) highest in Mx (37%). The most frequent cardiopulmonary imaging performed were cCT (61%)-more frequent in Mx and SAm-, and cX-ray (46%) -significantly used in CAC-. The cEcho was carried out in 18%, similarly among regions, and LUS in 7%, more frequently in Mx. The cMRI was performed in only one patient in the cohort. Abnormal findings on the cX-ray were related to peripheral (63%) or basal infiltrates (52%), and in cCT with ground glass infiltrates (89%). Both were more commonly in Mx. In LUS, interstitial syndrome (56%) was the most related abnormal finding, predominantly in Mx and CAC. ConclusionsThe use and findings of cardiopulmonary imaging in LATAM varied between regions and may have been influenced by clinical needs, the personnel protection measures and/or hospitalization location. Condensed AbstractThe SARS-Cov-2 is one of the largest and most active threats to healthcare in living memory. There is limited information on imaging services resources (ISR) used and their findings during the pandemic in LATAM. To our knowledge, RIMAC aimed the first international, multicenter study at registering the use and findings of cardiopulmonary imaging modalities performed for the diagnosis, prognosis, and treatment of patients hospitalized for infection with SARS-CoV-2 in Latin America. We studied their demographic parameters, comorbidities, in-hospital events, laboratory results, and treatments focusing on their impact in clinical complications.