Chest X-ray for predicting mortality and the need for ventilatory support in COVID-19 patients presenting to the emergency department

Balbi, Maurizio; Caroli, Anna; Corsi, A; Milanese, Gianluca; Surace, A; Marco, Fabiano Di; Novelli, Luca; Silva, Mario; Lorini, Ferdinando Luca; Duca, Andrea; Cosentini, Roberto; Sverzellati, Nicola; Bonaffini, Pietro Andrea; Sironi, Sandro

doi:10.1007/s00330-020-07270-1

Cited by 104 publications

(158 citation statements)

References 26 publications

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“…Mortality in other Italian hospitals in northern Italy varied between 43.6% ( 74 ) and 23.2% ( 75 ). In other hospitals in the Lombardy area, mortality ranged from 14.4 to 36.7% ( 75 – 80 ). Including our data, during the first epidemic wave the overall average in-hospital mortality in Italy therefore ranged around 30%.…”

Section: Shadows Lights and Lessons From Covidmentioning

confidence: 99%

The Many Faces of Covid-19 at a Glance: A University Hospital Multidisciplinary Account From Milan, Italy

Priori

Baisi

Banderali

et al. 2021

Front. Public Health

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In March 2020, northern Italy became the second country worldwide most affected by Covid-19 and the death toll overtook that in China. Hospital staff soon realized that Covid-19 was far more severe than expected from the few data available at that time. The Covid-19 pandemic forced hospitals to adjust to rapidly changing circumstances. We report our experience in a general teaching hospital in Milan, the capital of Lombardy, the most affected area in Italy. First, we briefly describe Lombardy's regional Covid-19-related health organizational changes as well as general hospital reorganization. We also provide a multidisciplinary report of the main clinical, radiological and pathological Covid-19 findings we observed in our patients.

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Section: Shadows Lights and Lessons From Covidmentioning

confidence: 99%

The Many Faces of Covid-19 at a Glance: A University Hospital Multidisciplinary Account From Milan, Italy

Priori

Baisi

Banderali

et al. 2021

Front. Public Health

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“…Moreover the American College of Radiology and Society of Thoracic Radiology in the United States cautioned against their widespread use for assessment and monitoring disease course (18). However several studies in Asia, Europe and United States have indicated that chest radiographs and CT may have a role in the prediction of clinical evolution including need of ICU admission (19)(20)(21)(22)(23)(24)(25).…”

Section: Introductionmentioning

confidence: 99%

The incremental value of computed tomography of COVID-19 pneumonia in predicting ICU admission

Bartolucci

Benelli

Betti

et al. 2021

Preprint

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RationaleTriage is crucial for patient’s management and estimation of the required Intensive Care Unit (ICU) beds is fundamental for Health Systems during the COVID-19 pandemic.ObjectiveTo assess whether chest Computed Tomography (CT) of COVID-19 pneumonia has an incremental role in predicting patient’s admission to ICU.MethodsWe performed volumetric and texture analysis of the areas of the affected lung in CT of 115 outpatients with COVID-19 infection presenting to the Emergency Room with dyspnea and unresponsive hypoxyemia. Admission blood laboratory including lymphocyte count, serum lactate dehydrogenase, D-dimer and C-Reactive Protein and the ratio between the arterial partial pressure of oxygen and inspired oxygen were collected. By calculating the areas under the receiver-operating characteristic curves (AUC), we compared the performance of blood laboratory-arterial gas analyses features alone and combined with the CT features in two hybrid models (Hybrid radiological and Hybrid radiomics)for predicting ICU admission. Following a machine learning approach, 63 patients were allocated to the training and 52 to the validation set.Measurements and Main ResultsTwenty-nine (25%) of patients were admitted to ICU. The Hybrid radiological model comprising the lung %consolidation performed significantly (p=0.04) better in predicting ICU admission in the validation (AUC=0.82; 95%Confidence Interval 0.68-0.95) set than the blood laboratory-arterial gas analyses features alone (AUC=0.71; 95%Confidence Interval 0.56-0.86). A risk calculator for ICU admission was derived and is available at:https://github.com/cgplab/covidappConclusionsThe volume of the consolidated lung in CT of patients with COVID-19 pneumonia has a mild but significant incremental value in predicting ICU admission.

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“…A total of thirteen studies 1 – 6 , 8 , 9 , 10 , 11 , 12 , 13 – 14 reporting 58,183 laboratory-confirmed COVID-19 patients were included. The main characteristics of the selected studies are demonstrated in Table 1 .…”

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confidence: 99%

Autoimmune diseases are independently associated with COVID-19 severity: Evidence based on adjusted effect estimates

Yang

Liang

et al. 2021

Journal of Infection

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Autoimmune diseases are independently associated with COVID-19 severity: Evidence based on adjusted effect estimatesThere have been several published articles reporting the association between autoimmune diseases and the risk of severity among patients with coronavirus disease 2019 (COVID-19). But the conclusions across studies are inconsistent. [1][2][3][4][5][6] Recently, Liu et al. performed a meta-analysis based on six studies with 2091 cases published in Journal of Infection to investigate the association between autoimmune diseases and severe or dead Their results demonstrated that autoimmune diseases were not significantly associated with severe or dead COVID-19 (odds ratio (OR) = 1.21, 95% confidence interval (CI): 0.58-2.50 for severity and OR = 1.31, 95% CI: 0.33-5.20 for mortality). 7 This is an extremely interesting paper. However, the number of included studies and sample sizes are limited. Up to now, several papers with large sample sizes on this topic are emerging. Therefore, it is required to clarify the association between autoimmune diseases and COVID-19 severity based on updated data.To our knowledge, several factors such as age, gender and underlying disorders (hypertension, diabetes, chronic obstructive pulmonary disease, cerebrovascular disease, cardiovascular disease, chronic kidney disease and obesity, etc.) significantly affected the clinical outcomes of COVID-19. This suggests that these risk factors might modulate the association of autoimmune diseases with COVID-19 severity. To obtain a precise conclusion, this metaanalysis was carried out based on published studies reporting adjusted effect estimates, rather than those reporting un-adjusted effect estimates.This meta-analysis was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. International databases of PubMed, Web of Science and EMBASE were searched to identify potential studies up to December 12, 2020. The following keywords were used: "coronavirus disease 2019 , "COVID-19 , "SARS-CoV-2 , "autoimmune diseases", "rheumatic diseases", "inflammatory bowel disease", "psoriasis" and "systemic lupus erythematosus". Only peerreviewed articles published in English reporting adjusted effect estimates on the association between autoimmune diseases and COVID-19 severity (severe, critical and mortal outcomes) were eligibly included. Repeated articles, case reports, reviews, comments, protocols, errata, and articles without sufficient information were excluded.Data were extracted by two independent authors (Jie Xu and Haiyan Yang) from each included study. Questions or disagreements were resolved by discussion or consultation with a third author (Yadong Wang). Baseline information extracted from the included literature includes author name, location, sample sizes,

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Chest X-ray for predicting mortality and the need for ventilatory support in COVID-19 patients presenting to the emergency department

Cited by 104 publications

References 26 publications

The Many Faces of Covid-19 at a Glance: A University Hospital Multidisciplinary Account From Milan, Italy

The Many Faces of Covid-19 at a Glance: A University Hospital Multidisciplinary Account From Milan, Italy

The incremental value of computed tomography of COVID-19 pneumonia in predicting ICU admission

Autoimmune diseases are independently associated with COVID-19 severity: Evidence based on adjusted effect estimates

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