tetano
Editor, Senior Moderator
Eur Radiol
. 2020 Jul 4;1-10.
doi: 10.1007/s00330-020-07033-y. Online ahead of print.
Chest CT Score in COVID-19 Patients: Correlation With Disease Severity and Short-Term Prognosis
Marco Francone[SUP] 1 [/SUP], Franco Iafrate[SUP] 2 [/SUP], Giorgio Maria Masci[SUP] 1 [/SUP], Simona Coco[SUP] 1 [/SUP], Francesco Cilia[SUP] 1 [/SUP], Lucia Manganaro[SUP] 1 [/SUP], Valeria Panebianco[SUP] 1 [/SUP], Chiara Andreoli[SUP] 3 [/SUP], Maria Chiara Colaiacomo[SUP] 3 [/SUP], Maria Antonella Zingaropoli[SUP] 4 [/SUP], Maria Rosa Ciardi[SUP] 4 [/SUP], Claudio Maria Mastroianni[SUP] 4 [/SUP], Francesco Pugliese[SUP] 5 [/SUP], Francesco Alessandri[SUP] 5 [/SUP], Ombretta Turriziani[SUP] 6 [/SUP], Paolo Ricci[SUP] 1 3 [/SUP], Carlo Catalano[SUP] 1 [/SUP]
Affiliations
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 (0:0%; 1, < 5%; 2:5-25%; 3:26-50%; 4:51-75%; 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.
Keywords: COVID-19; Pneumonia; Severe acute respiratory syndrome coronavirus 2; Tomography, X-ray computed.
. 2020 Jul 4;1-10.
doi: 10.1007/s00330-020-07033-y. Online ahead of print.
Chest CT Score in COVID-19 Patients: Correlation With Disease Severity and Short-Term Prognosis
Marco Francone[SUP] 1 [/SUP], Franco Iafrate[SUP] 2 [/SUP], Giorgio Maria Masci[SUP] 1 [/SUP], Simona Coco[SUP] 1 [/SUP], Francesco Cilia[SUP] 1 [/SUP], Lucia Manganaro[SUP] 1 [/SUP], Valeria Panebianco[SUP] 1 [/SUP], Chiara Andreoli[SUP] 3 [/SUP], Maria Chiara Colaiacomo[SUP] 3 [/SUP], Maria Antonella Zingaropoli[SUP] 4 [/SUP], Maria Rosa Ciardi[SUP] 4 [/SUP], Claudio Maria Mastroianni[SUP] 4 [/SUP], Francesco Pugliese[SUP] 5 [/SUP], Francesco Alessandri[SUP] 5 [/SUP], Ombretta Turriziani[SUP] 6 [/SUP], Paolo Ricci[SUP] 1 3 [/SUP], Carlo Catalano[SUP] 1 [/SUP]
Affiliations
- PMID: 32623505
- PMCID: PMC7334627
- DOI: 10.1007/s00330-020-07033-y
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 (0:0%; 1, < 5%; 2:5-25%; 3:26-50%; 4:51-75%; 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.
Keywords: COVID-19; Pneumonia; Severe acute respiratory syndrome coronavirus 2; Tomography, X-ray computed.