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

Ahlstrand, Erik; Cajander, Sara; Cajander, Per; Ingberg, Edvin; Löf, Erika; Wegener, Matthias; Lidén, Mats

doi:10.1101/2020.10.30.20222471

Cited by 7 publications

(13 citation statements)

References 23 publications

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“…Another study on baseline chest CT scans and clinical and laboratory data of 72 patients admitted with COVID-19 pneumonia showed lung severity score > was associated with a significantly lower recovery rate and discharge and extended hospitalization in patients admitted for COVID-19 pneumonia [ 29 ]. Similar to our findings, Ahlstrand et al previously reported that chest CT score at hospital admission correlates closely with hospital length of stay and ICU admission [ 30 ]. CT severity score combined with age and history of at least one underlying disease had 79.7% sensitivity and 65.5% specificity in predicting the adverse outcomes in a previous study [ 31 ].…”

Section: Discussionsupporting

confidence: 92%

Predictors of the chest CT score in COVID-19 patients: a cross-sectional study

Yazdi

Ghadery

SeyedAlinaghi

et al. 2021

Virol J

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Background Since the COVID-19 outbreak, pulmonary involvement was one of the most significant concerns in assessing patients. In the current study, we evaluated patient’s signs, symptoms, and laboratory data on the first visit to predict the severity of pulmonary involvement and their outcome regarding their initial findings. Methods All referred patients to the COVID-19 clinic of a tertiary referral university hospital were evaluated from April to August 2020. Four hundred seventy-eight COVID-19 patients with positive real-time reverse-transcriptase-polymerase chain reaction (RT-PCR) or highly suggestive symptoms with computed tomography (CT) imaging results with typical findings of COVID-19 were enrolled in the study. The clinical features, initial laboratory, CT findings, and short-term outcomes (ICU admission, mortality, length of hospitalization, and recovery time) were recorded. In addition, the severity of pulmonary involvement was assessed using a semi-quantitative scoring system (0–25). Results Among 478 participants in this study, 353 (73.6%) were admitted to the hospital, and 42 (8.7%) patients were admitted to the ICU. Myalgia (60.4%), fever (59.4%), and dyspnea (57.9%) were the most common symptoms of participants at the first visit. A review of chest CT scans showed that Ground Glass Opacity (GGO) (58.5%) and consolidation (20.7%) were the most patterns of lung lesions. Among initial clinical and laboratory findings, anosmia (P = 0.01), respiratory rate (RR) with a cut point of 25 (P = 0.001), C-reactive protein (CRP) with a cut point of 90 (P = 0.002), white Blood Cell (WBC) with a cut point of 10,000 (P = 0.009), and SpO2 with a cut point of 93 (P = 0.04) was associated with higher chest CT score. Lung involvement and consolidation lesions on chest CT scans were also associated with a more extended hospitalization and recovery period. Conclusions Initial assessment of COVID-19 patients, including symptoms, vital signs, and routine laboratory tests, can predict the severity of lung involvement and unfavorable outcomes.

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Section: Discussionsupporting

confidence: 92%

Predictors of the chest CT score in COVID-19 patients: a cross-sectional study

Yazdi

Ghadery

SeyedAlinaghi

et al. 2021

Virol J

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“…At study site 1 (Örebro) structured chest CT assessment of radiological lung involvement was part of the regional clinical routine in the evaluation of hypoxemic COVID-19 patients on hospital admission and was often repeated if patients deteriorated (22). Serum samples from hospitalized patients were collected on days 0 (day of enrollment), 2, and 4, and from non-hospitalized patients on day 0, and analyzed for eCIRP concentrations.…”

Section: Study Protocolmentioning

confidence: 99%

Serum concentration of extracellular cold-inducible RNA-binding protein is associated with respiratory failure in COVID-19

et al. 2022

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Uncontrolled release of damage-associated molecular patterns (DAMPs) is suggested to be a major trigger for the dysregulated host immune response that leads to severe COVID-19. Cold-inducible RNA-binding protein (CIRP), is a newly identified DAMP that aggravates inflammation and tissue injury, and induces respiratory failure in sepsis. Whether CIRP contributes to the pathogenesis of respiratory failure in COVID-19 has not yet been explored.AimTo investigate if the concentration of extracellular CIRP (eCIRP) in serum associates with respiratory failure and lung involvement by chest computed tomography (CT) in COVID-19.MethodsHerein we report a prospective observational study of patients with COVID-19 included at two University Hospitals in Sweden between April 2020 and May 2021. Serum from hospitalized patients in Örebro (N=97) were used to assess the association between eCIRP and the level of respiratory support and its correlation with pulmonary involvement on chest CT and inflammatory biomarkers. A cohort of hospitalized and non-hospitalized patients from Umeå (N=78) was used as an external validation cohort. The severity of disease was defined according to the highest degree of respiratory support; mild disease (no oxygen), non-severe hypoxemia (conventional oxygen or high-flow nasal oxygen, HFNO <50% FiO2), and severe hypoxemia (HFNO ≥50% FiO2, mechanical ventilation). Unadjusted and adjusted linear regression was used to evaluate peak eCIRP day 0-4 in respect to severity, age, sex, Charlson comorbidity score, symptom duration, and BMI.ResultsPeak eCIRP concentrations were higher in patients with severe hypoxemia and were independently associated with the degree of respiratory support in both cohorts (Örebro; p=0.01, Umeå; p<0.01). The degree of pulmonary involvement measured by CT correlated with eCIRP, rs=0.30, p<0.01 (n=97).ConclusionHigh serum levels of eCIRP are associated with acute respiratory failure in COVID-19. Experimental studies are needed to determine if treatments targeting eCIRP reduces the risk of acute respiratory failure in COVID-19.

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“…previously reported that chest CT score at hospital admission correlates closely with hospital length of stay and ICU admission (30). CT severity score combined with age and history of at least one underlying disease had 79.7% sensitivity and 65.5% speci city in predicting the adverse outcomes in a previous study (31).…”

Section: Chest Ct Predictors Of Unfavorable Outcomesmentioning

confidence: 73%

Predictors of The Chest CT Score in COVID-19 Patients: A Cross-Sectional Study

Yazdi

Ghadery

SeyedAlinaghi

et al. 2021

Preprint

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Background: Since the COVID-19 outbreak, pulmonary involvement was one of the most significant concerns in assessing patients. In the current study, we evaluated patient’s signs, symptoms, and laboratory data on the first visit to predict the severity of pulmonary involvement and their outcome regarding their initial findings.Methods: All referred patients to the CODID-19 clinic of a tertiary referral university hospital were evaluated from April to August 2020. Four hundred seventy-eight COVID-19 patients with positive real-time reverse-transcriptase-polymerase chain reaction (RT-PCR) or highly suggestive symptoms with computed tomography(CT) imaging results with typical findings of COVID-19 were enrolled in the study. The clinical features, initial laboratory, CT findings, and short-term outcomes (ICU admission, mortality, length of hospitalization, and recovery time) were recorded. In addition, the severity of pulmonary involvement was assessed using a semi-quantitative scoring system (0-25). Results: Among 478 participants in this study, 353 (73.6%) were admitted to the hospital, and 57 (11.9%) patients were admitted to the ICU. Myalgia (60.3%), fever (59.3%), and dyspnea (57.8%) were the most common symptoms of participants at the first visit. A review of chest CT scans showed that Ground Glass Opacity (GGO) (58.5%) and consolidation (20.7%) were the most patterns of lung lesions. Among initial clinical and laboratory findings, anosmia (P = 0.01), respiratory rate (RR) with a cut point of 25 (P = 0.001), C-reactive protein (CRP) with a cut point of 90 (P = 0.002), white Blood Cell (WBC) with a cut point of 10,000 (P = 0.009), and SpO2 with a cut point of 93 (P = 0.04) was associated with higher chest CT score. Lung involvement and consolidation lesions on chest CT scans were also associated with a more extended hospitalization and recovery period.Conclusions: Initial assessment of COVID-19 patients, including symptoms, vital signs, and routine laboratory tests, can predict the severity of lung involvement and unfavorable outcomes.

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

Cited by 7 publications

References 23 publications

Predictors of the chest CT score in COVID-19 patients: a cross-sectional study

Predictors of the chest CT score in COVID-19 patients: a cross-sectional study

Serum concentration of extracellular cold-inducible RNA-binding protein is associated with respiratory failure in COVID-19

Predictors of The Chest CT Score in COVID-19 Patients: A Cross-Sectional Study

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