Objective: In patients with mild COVID-19 pneumonia, chest high-resolution computed tomography (HRCT) is advised when risk factors for severe disease (i.e., age > 65 years and/or comorbidities) are present, and can influence management strategy. The objective was to assess whether HRCT is associated to short-time development of severe disease in patients with COVID-19 pneumonia.Methods: Seventy-seven consecutive patients (mean age, 64 +/- 15 years) with mild COVID-19 pneumonia (no or mild respiratory failure) that underwent HRCT were retrospectively identified. Fifty-two on 77 patients had reported risk factors for severe disease. A chest-imaging devoted radiologist recorded, on a per-examination basis, the following HRCT features: ground-glass opacity, crazy-paving pattern, consolidation, organizing pneumonia (OP) pattern, mosaic attenuation, and nodules. The extent of each feature (total feature score, TFS) was semi-quantitatively assessed. Total lung involvement (TLI) was defined as the sum of all TFSs. The study outcome was defined as the occurrence of severe disease (moderate-to-severe respiratory failure) within 15 days from HRCT. Logistic regression analysis was performed to assess if age, comorbidities, and HRCT features were associated to severe disease. Results: On univariable analysis, severe disease was significantly associated with age > 59 years (29/47 patients, 61.7%) (p = 0.013), and not significantly associated with having comorbidities (22/44 patients, 50.0%). On multivariable analysis, TLI >15 and OP pattern >5 were independently associated to severe disease, with odds ratio of 8.380 (p = 0.003), and of 4.685 (p = 0.035), respectively.Conclusion: Short-time onset of severe COVID-19 was associated to TLI >15 and OP pattern score > 5. Severe disease was not associated to comorbidities.

Chest high-resolution computed tomography is associated to short-time progression to severe disease in patients with COVID-19 pneumonia

Cereser, Lorenzo
Primo
;
Da Re, Jacopo;Zuiani, Chiara
Penultimo
;
Girometti, Rossano
Ultimo
2021-01-01

Abstract

Objective: In patients with mild COVID-19 pneumonia, chest high-resolution computed tomography (HRCT) is advised when risk factors for severe disease (i.e., age > 65 years and/or comorbidities) are present, and can influence management strategy. The objective was to assess whether HRCT is associated to short-time development of severe disease in patients with COVID-19 pneumonia.Methods: Seventy-seven consecutive patients (mean age, 64 +/- 15 years) with mild COVID-19 pneumonia (no or mild respiratory failure) that underwent HRCT were retrospectively identified. Fifty-two on 77 patients had reported risk factors for severe disease. A chest-imaging devoted radiologist recorded, on a per-examination basis, the following HRCT features: ground-glass opacity, crazy-paving pattern, consolidation, organizing pneumonia (OP) pattern, mosaic attenuation, and nodules. The extent of each feature (total feature score, TFS) was semi-quantitatively assessed. Total lung involvement (TLI) was defined as the sum of all TFSs. The study outcome was defined as the occurrence of severe disease (moderate-to-severe respiratory failure) within 15 days from HRCT. Logistic regression analysis was performed to assess if age, comorbidities, and HRCT features were associated to severe disease. Results: On univariable analysis, severe disease was significantly associated with age > 59 years (29/47 patients, 61.7%) (p = 0.013), and not significantly associated with having comorbidities (22/44 patients, 50.0%). On multivariable analysis, TLI >15 and OP pattern >5 were independently associated to severe disease, with odds ratio of 8.380 (p = 0.003), and of 4.685 (p = 0.035), respectively.Conclusion: Short-time onset of severe COVID-19 was associated to TLI >15 and OP pattern score > 5. Severe disease was not associated to comorbidities.
File in questo prodotto:
File Dimensione Formato  
HRCT COVID Clin Imaging 2021.pdf

non disponibili

Tipologia: Versione Editoriale (PDF)
Licenza: Non pubblico
Dimensione 1.34 MB
Formato Adobe PDF
1.34 MB Adobe PDF   Visualizza/Apri   Richiedi una copia
1-s2.0-S0899707120304010-main(1).pdf

non disponibili

Tipologia: Versione Editoriale (PDF)
Licenza: Non pubblico
Dimensione 1.3 MB
Formato Adobe PDF
1.3 MB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11390/1259144
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 4
  • ???jsp.display-item.citation.isi??? 5
social impact