CT-Based Risk Stratification for Intensive Care Need and Survival in COVID-19 Patients-A Simple Solution.
Clarissa HosseLaura BüttnerFlorian Nima FleckensteinChristina Maria HamperMartin JonczykOriane ScholzAnnette AignerGeorg BöningPublished in: Diagnostics (Basel, Switzerland) (2021)
We evaluated a simple semi-quantitative (SSQ) method for determining pulmonary involvement in computed tomography (CT) scans of COVID-19 patients. The extent of lung involvement in the first available CT was assessed with the SSQ method and subjectively. We identified risk factors for the need of invasive ventilation, intensive care unit (ICU) admission and for time to death after infection. Additionally, the diagnostic performance of both methods was evaluated. With the SSQ method, a 10% increase in the affected lung area was found to significantly increase the risk for need of ICU treatment with an odds ratio (OR) of 1.68 and for invasive ventilation with an OR of 1.35. Male sex, age, and pre-existing chronic lung disease were also associated with higher risks. A larger affected lung area was associated with a higher instantaneous risk of dying (hazard ratio (HR) of 1.11) independently of other risk factors. SSQ measurement was slightly superior to the subjective approach with an AUC of 73.5% for need of ICU treatment and 72.7% for invasive ventilation. SSQ assessment of the affected lung in the first available CT scans of COVID-19 patients may support early identification of those with higher risks for need of ICU treatment, invasive ventilation, or death.
Keyphrases
- computed tomography
- intensive care unit
- mechanical ventilation
- dual energy
- contrast enhanced
- image quality
- positron emission tomography
- sars cov
- risk factors
- magnetic resonance imaging
- respiratory failure
- emergency department
- acute respiratory distress syndrome
- risk assessment
- magnetic resonance
- pulmonary hypertension
- combination therapy
- climate change
- human health
- palliative care
- high resolution
- mass spectrometry
- replacement therapy
- extracorporeal membrane oxygenation
- smoking cessation
- free survival