tetano
Editor, Senior Moderator
J Infect Chemother
. 2023 Jan 7;S1341-321X(23)00003-X.
doi: 10.1016/j.jiac.2022.12.016. Online ahead of print.
Are the thorax Computed Tomography findings OF ICU patients diagnosed with COVID-19 pneumonia related to the duration of hospital stay and mortality?
Ümmihan Topal[SUP] 1 [/SUP], Gülseren Yılmaz[SUP] 2 [/SUP], Ayça Sultan Şahin[SUP] 2 [/SUP]
Affiliations
Abstract
Introduction: Quantitative thorax Computed Tomography (CT) is used to determine the severity of COVID-19 pneumonia. With a new approach, quantitative thoracic CT is to contribute to the triage of patients with severe COVID-19 pneumonia in the ICU and to evaluate its relation with mortality by taking into account the vaccination status.
Methods: Fifty-six patients who had a diagnosis of COVID-19 pneumonia confirmed in the adult ICU were evaluated retrospectively. To evaluate the degree of parenchymal involvement, the quantitative CT "craniocaudal diameter of the thorax/craniocaudal largest lesion diameter (CCDT/CCDL)" ratio and semi-quantitative total CT severity scores (TCTSS) (0:0%; 1:1-25%; 2:26-50%; 3:51-75% and 4:76-100%) were calculated. Both methods were analyzed with comparative ROC curves for predicting mortality. The effects of vaccines on thorax CT findings and laboratory parameters were also investigated.
Results: The sensitivities and specificities were found to be 72.5%, 75.61%, and 80%, 73.33% when CCDT/CCDL and TCTSS cutoff value was taken <1.4, and >9, respectively, to predict mortality in COVID-19 pneumonia (Area Under the Curve = AUC = 0.797 and 0.752). Both methods predicted mortality well and no statistical differences were detected between them (p = 0.3618). In vaccinated patients, CRP was higher (p = 0.045), and LDH and ferritin were lower (p = 0.049, p = 0.004). The number of lobes involved was lower in the vaccinated group (p = 0.001).
Conclusions: The quantitative CT score (CCDT/CCDL) may play as important a role as TCTSS in diagnosing COVID-19 pneumonia, determining the severity of the disease, and predicting the related mortality. COVID-19 vaccines may affect laboratory parameters and cause less pneumonia on thoracic CT than in unvaccinated individuals.
Keywords: COVID-19 vaccine; Intensive care units; Messenger RNA Vaccines; Multidetector computed tomography; Severe acute respiratory syndrome coronavirus 2.
. 2023 Jan 7;S1341-321X(23)00003-X.
doi: 10.1016/j.jiac.2022.12.016. Online ahead of print.
Are the thorax Computed Tomography findings OF ICU patients diagnosed with COVID-19 pneumonia related to the duration of hospital stay and mortality?
Ümmihan Topal[SUP] 1 [/SUP], Gülseren Yılmaz[SUP] 2 [/SUP], Ayça Sultan Şahin[SUP] 2 [/SUP]
Affiliations
- PMID: 36627082
- DOI: 10.1016/j.jiac.2022.12.016
Abstract
Introduction: Quantitative thorax Computed Tomography (CT) is used to determine the severity of COVID-19 pneumonia. With a new approach, quantitative thoracic CT is to contribute to the triage of patients with severe COVID-19 pneumonia in the ICU and to evaluate its relation with mortality by taking into account the vaccination status.
Methods: Fifty-six patients who had a diagnosis of COVID-19 pneumonia confirmed in the adult ICU were evaluated retrospectively. To evaluate the degree of parenchymal involvement, the quantitative CT "craniocaudal diameter of the thorax/craniocaudal largest lesion diameter (CCDT/CCDL)" ratio and semi-quantitative total CT severity scores (TCTSS) (0:0%; 1:1-25%; 2:26-50%; 3:51-75% and 4:76-100%) were calculated. Both methods were analyzed with comparative ROC curves for predicting mortality. The effects of vaccines on thorax CT findings and laboratory parameters were also investigated.
Results: The sensitivities and specificities were found to be 72.5%, 75.61%, and 80%, 73.33% when CCDT/CCDL and TCTSS cutoff value was taken <1.4, and >9, respectively, to predict mortality in COVID-19 pneumonia (Area Under the Curve = AUC = 0.797 and 0.752). Both methods predicted mortality well and no statistical differences were detected between them (p = 0.3618). In vaccinated patients, CRP was higher (p = 0.045), and LDH and ferritin were lower (p = 0.049, p = 0.004). The number of lobes involved was lower in the vaccinated group (p = 0.001).
Conclusions: The quantitative CT score (CCDT/CCDL) may play as important a role as TCTSS in diagnosing COVID-19 pneumonia, determining the severity of the disease, and predicting the related mortality. COVID-19 vaccines may affect laboratory parameters and cause less pneumonia on thoracic CT than in unvaccinated individuals.
Keywords: COVID-19 vaccine; Intensive care units; Messenger RNA Vaccines; Multidetector computed tomography; Severe acute respiratory syndrome coronavirus 2.