Infect Chemother.  2021 Jun;53(2):308-318. 10.3947/ic.2021.0024.

Chest Computed Tomography Severity Score to Predict Adverse Outcomes of Patients with COVID-19

Affiliations
  • 1Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran
  • 2Department of Epidemiology and Biostatistics, Isfahan University of Medical Sciences, Isfahan, Iran
  • 3Department of Radiology, Kashan University of Medical Sciences, Kashan, Iran
  • 4Department of Industrial and Systems Engineering, Isfahan University of Technology, Isfahan, Iran
  • 5Center for Optimization and Intelligent Decision making in Healthcare systems (COID-Health), Isfahan University of Technology, Isfahan, Iran
  • 6Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background
The novel coronavirus disease 2019 (COVID-19) continues to wreak havoc worldwide. This study assessed the ability of chest computed tomography (CT) severity score (CSS) to predict intensive care unit (ICU) admission and mortality in patients with COVID-19 pneumonia.
Materials and Methods
A total of 192 consecutive patients with COVID-19 pneumonia aged more than 20 years and typical CT findings and reverse-transcription polymerase chain reaction positive admitted in a tertiary hospital were included. Clinical symptoms at admission and short-term outcome were obtained. A semi-quantitative scoring system was used to evaluate the parenchymal involvement. The association between CSS, disease severity, and outcomes were evaluated. Prediction of CSS was assessed with the area under the receiver-operating characteristic (ROC) curves.
Results
The incidence of admission to ICU was 22.8% in men and 14.1% in women. CSS was related to ICU admission and mortality. Areas under the ROC curves were 0.764 for total CSS. Using a stepwise binary logistic regression model, gender, age, oxygen saturation, and CSS had a significant independent relationship with ICU admission and death. Patients with CSS ≥12.5 had about four-time risk of ICU admission and death (odds ratio 1.66, 95% confidence interval 1.66 – 9.25). The multivariate regression analysis showed the superiority of CSS over other clinical information and co-morbidities.
Conclusion
CSS was a strong predictor of progression to ICU admission and death and there was a substantial role of non-contrast chest CT imaging in the presence of typical features for COVID-19 pneumonia as a reliable predictor of clinical severity and patient’s outcome.

Keyword

Chest CT; COVID-19; Prognosis; SARS-CoV-2; CT severity score
Full Text Links
  • IC
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr