Relationship of Computed Tomography Severity Score With Patient Characteristics and Survival in Hypoxemic COVID-19 Patients

Yanamandra, Uday; Shobhit, Shivendra; Paul, Devashish; Aggarwal, Bhavya; Kaur, Praneet; Duhan, Gayatri; Singh, Anurag K.; Srinath, Rajagopal; Saxena, Puneet; Menon, Anil S.

doi:10.7759/cureus.22847

Cited by 6 publications

(7 citation statements)

References 31 publications

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“…Their identification and the volumetric quantification may allow an easier classification in terms of gravity, extent and progression of the disease. Moreover, this may provide a high-impact tool to enhance awareness of the severity of COVID-19 pneumonia [ 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 ].…”

Section: Introductionmentioning

confidence: 99%

Imaging Severity COVID-19 Assessment in Vaccinated and Unvaccinated Patients: Comparison of the Different Variants in a High Volume Italian Reference Center

Granata

Fusco

Villanacci

et al. 2022

JPM

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Purpose: To analyze the vaccine effect by comparing five groups: unvaccinated patients with Alpha variant, unvaccinated patients with Delta variant, vaccinated patients with Delta variant, unvaccinated patients with Omicron variant, and vaccinated patients with Omicron variant, assessing the “gravity” of COVID-19 pulmonary involvement, based on CT findings in critically ill patients admitted to Intensive Care Unit (ICU). Methods: Patients were selected by ICU database considering the period from December 2021 to 23 March 2022, according to the following inclusion criteria: patients with proven Omicron variant COVID-19 infection with known COVID-19 vaccination with at least two doses and with chest Computed Tomography (CT) study during ICU hospitalization. Wee also evaluated the ICU database considering the period from March 2020 to December 2021, to select unvaccinated consecutive patients with Alpha variant, subjected to CT study, consecutive unvaccinated and vaccinated patients with Delta variant, subjected to CT study, and, consecutive unvaccinated patients with Omicron variant, subjected to CT study. CT images were evaluated qualitatively using a severity score scale of 5 levels (none involvement, mild: ≤25% of involvement, moderate: 26–50% of involvement, severe: 51–75% of involvement, and critical involvement: 76–100%) and quantitatively, using the Philips IntelliSpace Portal clinical application CT COPD computer tool. For each patient the lung volumetry was performed identifying the percentage value of aerated residual lung volume. Non-parametric tests for continuous and categorical variables were performed to assess statistically significant differences among groups. Results: The patient study group was composed of 13 vaccinated patients affected by the Omicron variant (Omicron V). As control groups we identified: 20 unvaccinated patients with Alpha variant (Alpha NV); 20 unvaccinated patients with Delta variant (Delta NV); 18 vaccinated patients with Delta variant (Delta V); and 20 unvaccinated patients affected by the Omicron variant (Omicron NV). No differences between the groups under examination were found (p value > 0.05 at Chi square test) in terms of risk factors (age, cardiovascular diseases, diabetes, immunosuppression, chronic kidney, cardiac, pulmonary, neurologic, and liver disease, etc.). A different median value of aerated residual lung volume was observed in the Delta variant groups: median value of aerated residual lung volume was 46.70% in unvaccinated patients compared to 67.10% in vaccinated patients. In addition, in patients with Delta variant every other extracted volume by automatic tool showed a statistically significant difference between vaccinated and unvaccinated group. Statistically significant differences were observed for each extracted volume by automatic tool between unvaccinated patients affected by Alpha variant and vaccinated patients affected by Delta variant of COVID-19. Good statistically significant correlations among volumes extracted by automatic tool for each lung lobe and overall radiological severity score were obtained (ICC range 0.71–0.86). GGO was the main sign of COVID-19 lesions on CT images found in 87 of the 91 (95.6%) patients. No statistically significant differences were observed in CT findings (ground glass opacities (GGO), consolidation or crazy paving sign) among patient groups. Conclusion: In our study, we showed that in critically ill patients no difference were observed in terms of severity of disease or exitus, between unvaccinated and vaccinated patients. The only statistically significant differences were observed, with regard to the severity of COVID-19 pulmonary parenchymal involvement, between unvaccinated patients affected by Alpha variant and vaccinated patients affected by Delta variant, and between unvaccinated patients with Delta variant and vaccinated patients with Delta variant.

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Section: Introductionmentioning

confidence: 99%

Imaging Severity COVID-19 Assessment in Vaccinated and Unvaccinated Patients: Comparison of the Different Variants in a High Volume Italian Reference Center

Granata

Fusco

Villanacci

et al. 2022

JPM

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“…Concerning D dimer, an average of 320 ug/L was obtained in the Egyptian study [23] and 434 ug/L in the Indian study by Yanamandra [30], values well below those found in Huancayo where the average D dimer was 1295 ug/L in mild cases. The Egyptian study's patients with severe tomographic pulmonary compromise had an average D-dimer of 1210 ug/L.…”

Section: Discussionmentioning

confidence: 59%

“…In contrast, in the Indian study its average value was 29 mg/dL, values much lower than those found in our population, in which patients with mild compromise had an average of 69.8 mg/dL of C-reactive protein. The moderate cases of the study from India [30] had an average CRP of 66.6, which was even below the values of the mild cases from Huancayo, where the patients with moderate involvement had an average C-reactive protein of 130.5. mg/dL.…”

Section: Discussionmentioning

confidence: 59%

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Relationship between the Severity of Chest CT Scan Lesions, Arterial Oxygenation and Inflammatory Markers in High – Altitude Patients with Covid-19

Calderón-Gerstein¹,

Samaniego²,

Pazos-Sovero³

et al. 2023

OBM Genet

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This study aims to determine the relationship between the severity of lung tomographic compromise with arterial oxygenation and inflammatory markers in patients with COVID-19, and to evaluate the relationship between the CTSS tomographic severity score and the mortality risk in a high-altitude population. A retrospective, longitudinal study reviewed medical records between January and July of 2021 at the Daniel Alcides Carrión Regional Teaching Clinical Surgical Hospital in Huancayo. Categorical variables were analyzed with the chi-square test, continuous variables with the ANOVA test, and correlations between continuous variables were calculated by calculating Spearman's coefficient. The predictive capacity of the CTSS score was evaluated by determining the ROC curve. Two hundred-three medical records were reviewed; 65% of patients (n = 132) were male and 84.7% came from Huancayo (n = 172). The average age was 55.86 years. 58.6% of the CT scans were in the peak phase and 14.3% in the progressive phase. The average value of the PaO2/FiO2 ratio in deceased patients was 107.4; in survivors it was 196.10. Mortality was 12% in those with mild lesions, 28.8% in those with moderate involvement, and 79.2% in those with severe pulmonary lesions. PO2/FiO2, SatO2/FiO2, DHL, CRP, D-dimer, and lymphopenia correlated with the severity of pulmonary tomographic patterns. Tomographic lesions and inflammatory marker values were more severe than in most international studies.

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“… 35 Admission hyperglycemia, elevated d-dimer, and high HRCT score are potential risk factors for adverse outcomes and death. 34 , 36 Shang et al, demonstrated that the incidence of respiratory failure (p-0·022), acute cardiac injury (p < 0·01), and death (p-0·001) in the diabetes group was significantly higher than that in the non-diabetes group. 32 Another study done by Chen et al, in China showed C-reactive protein might help identify patients with diabetes who are at greater risk of dying during hospitalization (p-0·043).…”

Section: Discussionmentioning

confidence: 99%

Sweetness and positivity together aren't a happy ending: Case controlled study amongst severe COVID-19 for impact of diabetes mellitus on survival

Yanamandra¹,

Srinath²,

Aggarwal³

et al. 2024

Medical Journal Armed Forces India

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Relationship of Computed Tomography Severity Score With Patient Characteristics and Survival in Hypoxemic COVID-19 Patients

Cited by 6 publications

References 31 publications

Imaging Severity COVID-19 Assessment in Vaccinated and Unvaccinated Patients: Comparison of the Different Variants in a High Volume Italian Reference Center

Imaging Severity COVID-19 Assessment in Vaccinated and Unvaccinated Patients: Comparison of the Different Variants in a High Volume Italian Reference Center

Relationship between the Severity of Chest CT Scan Lesions, Arterial Oxygenation and Inflammatory Markers in High – Altitude Patients with Covid-19

Sweetness and positivity together aren't a happy ending: Case controlled study amongst severe COVID-19 for impact of diabetes mellitus on survival

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