Etienne Charpentier1,2, Gilles Soulat1,2,3, Antoine Fayol1,3,4, Anne Hernigou1,2, Marine Livrozet1,4, Teodor Grand1,2, Guillaume Reverdito1,2, Jad Al Haddad1,2, Kim Diep Dang Tran1,2, Anne Charpentier1,2, Olivier Clement1,2,3, Jean-Sebastien Hulot1,3,4, Elie Mousseaux5,6,7,8. 1. Université de Paris, F-75015, Paris, France. 2. Department of Radiology, Assistance Publique Hôpitaux des Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou (HEGP), Paris, France. 3. Institut National de la Santé et de la Recherche Médicale, PARCC, UMR970, F-75015, Paris, France. 4. CIC1418 and DMU CARTE, Assistance Publique Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, F-75015, Paris, France. 5. Université de Paris, F-75015, Paris, France. elie.mousseaux@aphp.fr. 6. Department of Radiology, Assistance Publique Hôpitaux des Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou (HEGP), Paris, France. elie.mousseaux@aphp.fr. 7. Institut National de la Santé et de la Recherche Médicale, PARCC, UMR970, F-75015, Paris, France. elie.mousseaux@aphp.fr. 8. Service de Radiologie, Hôpital Européen Georges Pompidou, 20-40 rue Leblanc, 75015, Paris, France. elie.mousseaux@aphp.fr.
Abstract
OBJECTIVES: Chest CT has been widely used to screen and to evaluate the severity of COVID-19 disease in the early stages of infection without severe acute respiratory syndrome, but no prospective data are available to study the relationship between extent of lung damage and short-term mortality. The objective was to evaluate association between standardized simple visual lung damage CT score (vldCTs) at admission, which does not require any software, and 30-day mortality. METHODS: In a single-center prospective cohort of COVID-19 patients included during 4 weeks, the presence and extent of ground glass opacities(GGO), consolidation opacities, or both of them were visually assessed in each of the 5 lung lobes (score from 0 to 4 per lobe depending on the percentage and out of 20 per patient = vldCTs) after the first chest CT performed to detect COVID-19 pneumonia. RESULTS: Among 210 confirmed COVID-19 patients, the number of survivors and non-survivors was 162 (77%) and 48 (23%), respectively at 30 days. vldCTs was significantly higher in non-survivors, and the AUC of vldCTs to distinguish survivors and non-survivors was 0.72 (95%CI 0.628-0.807, p < 0.001); the best cut-off vldCTs value was 7. During follow-up, significant differences in discharges and 30-day mortality were observed between patients with vldCTs ≥ 7 versus vldCTs < 7: (98 [85.2%] vs 49 [51.6%]; p < 0.001 and 36 [37.9%] vs 12 [12.4%]; p < 0.001, respectively. The 30-day mortality increased if vldCTs ≥ 7 (HR, 3.16 (1.50-6.43); p = 0.001), independent of age, respiratory rate and oxygen saturation levels, and comorbidities at admission. CONCLUSIONS: By using chest CT in COVID-19 patients, extensive lung damage can be visually assessed with a score related to 30-day mortality independent of conventional risk factors of the disease. KEY POINTS: • In non-selected COVID-19 patients included prospectively during 4 weeks, the extent of ground glass opacities(GGO) and consolidation opacities evaluated by a simple visual score was related to 30-day mortality independent of age, respiratory rate, oxygen saturation levels, comorbidities, and hs-troponin I level at admission. • This severity score should be incorporated into risk stratification algorithms and in structured chest CT reports requiring a standardized reading by radiologists in case of COVID-19.
OBJECTIVES: Chest CT has been widely used to screen and to evaluate the severity of COVID-19 disease in the early stages of infection without severe acute respiratory syndrome, but no prospective data are available to study the relationship between extent of lung damage and short-term mortality. The objective was to evaluate association between standardized simple visual lung damage CT score (vldCTs) at admission, which does not require any software, and 30-day mortality. METHODS: In a single-center prospective cohort of COVID-19patients included during 4 weeks, the presence and extent of ground glass opacities(GGO), consolidation opacities, or both of them were visually assessed in each of the 5 lung lobes (score from 0 to 4 per lobe depending on the percentage and out of 20 per patient = vldCTs) after the first chest CT performed to detect COVID-19 pneumonia. RESULTS: Among 210 confirmed COVID-19patients, the number of survivors and non-survivors was 162 (77%) and 48 (23%), respectively at 30 days. vldCTs was significantly higher in non-survivors, and the AUC of vldCTs to distinguish survivors and non-survivors was 0.72 (95%CI 0.628-0.807, p < 0.001); the best cut-off vldCTs value was 7. During follow-up, significant differences in discharges and 30-day mortality were observed between patients with vldCTs ≥ 7 versus vldCTs < 7: (98 [85.2%] vs 49 [51.6%]; p < 0.001 and 36 [37.9%] vs 12 [12.4%]; p < 0.001, respectively. The 30-day mortality increased if vldCTs ≥ 7 (HR, 3.16 (1.50-6.43); p = 0.001), independent of age, respiratory rate and oxygen saturation levels, and comorbidities at admission. CONCLUSIONS: By using chest CT in COVID-19patients, extensive lung damage can be visually assessed with a score related to 30-day mortality independent of conventional risk factors of the disease. KEY POINTS: • In non-selected COVID-19patients included prospectively during 4 weeks, the extent of ground glass opacities(GGO) and consolidation opacities evaluated by a simple visual score was related to 30-day mortality independent of age, respiratory rate, oxygen saturation levels, comorbidities, and hs-troponin I level at admission. • This severity score should be incorporated into risk stratification algorithms and in structured chest CT reports requiring a standardized reading by radiologists in case of COVID-19.
Entities:
Keywords:
COVID-19; Pneumonia; Severe acute respiratory syndrome; Tomography, x-ray computed
Authors: Fatemeh Homayounieh; Rosa Babaei; Hadi Karimi Mobin; Chiara D Arru; Maedeh Sharifian; Iman Mohseni; Eric Zhang; Subba R Digumarthy; Mannudeep K Kalra Journal: J Comput Assist Tomogr Date: 2020 Sep/Oct Impact factor: 1.826
Authors: Adam Bernheim; Xueyan Mei; Mingqian Huang; Yang Yang; Zahi A Fayad; Ning Zhang; Kaiyue Diao; Bin Lin; Xiqi Zhu; Kunwei Li; Shaolin Li; Hong Shan; Adam Jacobi; Michael Chung Journal: Radiology Date: 2020-02-20 Impact factor: 11.105