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Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Eur+Radiol 2020 ; 30 (12): 6808-17 Nephropedia Template TP
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Chest CT score in COVID-19 patients: correlation with disease severity and short-term prognosis #MMPMID32623505
Eur Radiol 2020[]; 30 (12): 6808-17 PMID32623505show ga
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.