Extension of COVID-19 pulmonary parenchyma lesions based on real-life visual assessment on initial chest CT is an independent predictor of poor patient outcome

Grégory, Jules; Raynaud, Lucas; Galy, Adrien; Corre, Félix; Bijot, Jean Charles; Nguyen, Yann; Vilgrain, Valérie

doi:10.1080/23744235.2020.1792544

Cited by 7 publications

(9 citation statements)

References 11 publications

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“…In addition, several semi-automatized [ 8 , 13 , 17 ] and computerized [ 7 , 18 , 19 ] quantitative measures of Covid-19 lung involvement on CT have been associated with outcomes related to a severe course of Covid-19. However, to the best of our knowledge, up to date only one smaller study, published as a letter to the editor, reported real-life data on the predictive role of CT visual scoring in clinical routine [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Visual scoring of chest CT at hospital admission predicts hospitalization time and intensive care admission in Covid-19

Ahlstrand

Cajander

et al. 2021

Infectious Diseases

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Background Chest CT is prognostic in Covid-19 but there is a lack of consensus on how to report the CT findings. A chest CT scoring system, ÖCoS, was implemented in clinical routine on 1 April 2020, in Örebro Region, Sweden. The ÖCoS-severity score measures the extent of lung involvement. The objective of the study was to evaluate the ÖCoS scores as predictors of the clinical course of Covid-19. Methods Population based study including data from all hospitalized patients with Covid-19 in Örebro Region during March to July 2020. We evaluated the correlations between CT scores at the time of admission to hospital and intensive care in relation to hospital and intensive care length of stay (LoS), intensive care admission and death. C-reactive protein and lymphocyte count were included as covariates in multivariate regression analyses. Results In 381 included patients, the ÖCoS-severity score at admission closely correlated to hospital length of stay, and intensive care admission or death. At admission to intensive care, the ÖCoS-severity score correlated with intensive care length of stay. The ÖCoS-severity score was superior to basic inflammatory biomarkers in predicting clinical outcomes. Conclusion Chest CT visual scoring at admission to hospital predicted the clinical course of Covid-19 pneumonia.

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Section: Discussionmentioning

confidence: 99%

Visual scoring of chest CT at hospital admission predicts hospitalization time and intensive care admission in Covid-19

Ahlstrand

Cajander

et al. 2021

Infectious Diseases

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“…In addition, several semi-automatized 8,13,17 and computerized 7,18,19 quantitative measures of covid-19 lung involvement on CT have been described to be associated with outcomes related to a severe course of covid-19. However, to the best of our knowledge, up to date only one smaller study, published as a letter to the editor, reported real-life data on the predictive role of CT visual scoring in clinical routine 20 .…”

Section: Discussionmentioning

confidence: 99%

Visual Scoring of Chest CT at Hospital Admission Predicts Hospitalization Time and Intensive Care Admission in Covid-19

Ahlstrand

Cajander

et al. 2020

Preprint

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Background The extent and character of lung involvement on chest computerized tomography (CT) have a prognostic value in covid-19 but there is lack of consensus on how to assess and stage CT features. A scoring system of lung involvement in covid-19, Örebro covid-19 Scale (ÖCoS) was implemented in clinical routine on April 1 2020 in Örebro Region, Sweden. The ÖCoS-severity score measures the extent of lung involvement while ÖCoS-temporal stage characterizes the parenchymal involvement. The objective of the present study was to evaluate the ÖCoS scores in relation to clinical outcome of covid-19. Methods Population based study including data from all hospitalized patients with covid-19 in Örebro Region during March to July 2020. Chest CT scores at the time of hospital admission and ICU admission were analyzed in relation to hospital and intensive care unit (ICU) length of stay, time to ICU admission and admission to ICU or death. Findings In the 381 included patients, there was a close correlation of the ÖCoS-severity score on admittance to hospital and the hospital length of stay. The ÖCoS-severity score on hospital admittance was a strong predictor for both a severe outcome in regards to ICU admittance or death and the time to ICU admittance. On admittance to ICU, both ÖCoS-severity score and temporal stage were correlated with the ICU length of stay. Interpretation Chest CT visual scoring on admission to hospital predicts the clinical course in covid-19 pneumonia. Funding This work was supported by the Örebro Region, Sweden.

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“…On a similar note, other studies quantify the percentage of pulmonary parenchyma affected by the disease, by evaluating both lungs as a whole, while using a simple visual percentage scaling system with scales ranging from 0 to 100% (Figure 1) [45,[49][50][51][52]. Specifically, in a study conducted by Guillo et al [49], the great majority of patients demonstrating more than 25% occupancy of the total lung parenchyma by COVID-19 opacities were either intubated or deceased in the first 3 weeks after the initial CT.…”

Section: Ct Imaging Findingsmentioning

confidence: 99%

“…Furthermore, Ahlstrand et al [52] found that the use of such a scoring system (0%, <10%, 10-25%, 25-50%, 50-75%, >75%) on admission CT could strongly predict inhospital mortality and ICU admission. Grégory et al [51] displayed that the extension of total pulmonary parenchyma affected by COVID-19 (<25%, 25-50%, 50-75%, >75%) could independently predict poor patient outcome and be correlated with the requirement of mechanical aeration and in-hospital mortality during the first 2 weeks. The above studies highlight the realization that obtaining and evaluating admission chest CTs based on the visually assessed burden of COVID-19 disease may predict ICU admission and in-hospital death, thus improving patient management and aiding in risk-stratification.…”

Section: Ct Imaging Findingsmentioning

confidence: 99%

The Role of Ionizing Radiation for Diagnosis and Treatment against COVID-19: Evidence and Considerations

Chalkia

Arkoudis

Maragkoudakis

et al. 2022

Cells

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The Coronavirus disease 2019 (COVID-19) pandemic continues to spread worldwide with over 260 million people infected and more than 5 million deaths, numbers that are escalating on a daily basis. Frontline health workers and scientists diligently fight to alleviate life-threatening symptoms and control the spread of the disease. There is an urgent need for better triage of patients, especially in third world countries, in order to decrease the pressure induced on healthcare facilities. In the struggle to treat life-threatening COVID-19 pneumonia, scientists have debated the clinical use of ionizing radiation (IR). The historical literature dating back to the 1940s contains many reports of successful treatment of pneumonia with IR. In this work, we critically review the literature for the use of IR for both diagnostic and treatment purposes. We identify details including the computed tomography (CT) scanning considerations, the radiobiological basis of IR anti-inflammatory effects, the supportive evidence for low dose radiation therapy (LDRT), and the risks of radiation-induced cancer and cardiac disease associated with LDRT. In this paper, we address concerns regarding the effective management of COVID-19 patients and potential avenues that could provide empirical evidence for the fight against the disease.

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Extension of COVID-19 pulmonary parenchyma lesions based on real-life visual assessment on initial chest CT is an independent predictor of poor patient outcome

Cited by 7 publications

References 11 publications

Visual scoring of chest CT at hospital admission predicts hospitalization time and intensive care admission in Covid-19

Visual scoring of chest CT at hospital admission predicts hospitalization time and intensive care admission in Covid-19

Visual Scoring of Chest CT at Hospital Admission Predicts Hospitalization Time and Intensive Care Admission in Covid-19

The Role of Ionizing Radiation for Diagnosis and Treatment against COVID-19: Evidence and Considerations

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