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Bucher AM, Sieren MM, Meinel FG, Kloeckner R, Fink MA, Sähn MJ, Wienke A, Meyer HJ, Penzkofer T, Dietz J, Vogl TJ, Borggrefe J, Surov A. Prevalence and prognostic role of thoracic lymphadenopathy in Covid-19. ROFO-FORTSCHR RONTG 2024. [PMID: 39038457 DOI: 10.1055/a-2293-8132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
PURPOSE The prevalent coronavirus disease 2019 (COVID-19) pandemic has spread throughout the world and is considered a serious threat to global health. The prognostic role of thoracic lymphadenopathy in COVID-19 is unclear. The aim of the present meta-analysis was to analyze the prognostic role of thoracic lymphadenopathy for the prediction of 30-day mortality in patients with COVID-19. MATERIALS AND METHODS The MEDLINE library, Cochrane, and SCOPUS databases were screened for associations between CT-defined features and mortality in COVID-19 patients up to June 2021. In total, 21 studies were included in the present analysis. The quality of the included studies was assessed by the Newcastle-Ottawa Scale. The meta-analysis was performed using RevMan 5.3. Heterogeneity was calculated by means of the inconsistency index I2. DerSimonian and Laird random-effect models with inverse variance weights were performed without any further correction. RESULTS The included studies comprised 4621 patients. The prevalence of thoracic lymphadenopathy varied between 1 % and 73.4 %. The pooled prevalence was 16.7 %, 95 % CI = (15.6 %; 17.8 %). The hospital mortality was higher in patients with thoracic lymphadenopathy (34.7 %) than in patients without (20.0 %). The pooled odds ratio for the influence of thoracic lymphadenopathy on mortality was 2.13 (95 % CI = [1.80-2.52], p < 0.001). CONCLUSION The prevalence of thoracic lymphadenopathy in COVID-19 is 16.7 %. The presence of thoracic lymphadenopathy is associated with an approximately twofold increase in the risk for hospital mortality in COVID-19. KEY POINTS · The prevalence of lymphadenopathy in COVID-19 is 16.7 %.. · Patients with lymphadenopathy in COVID-19 have a higher risk of mortality during hospitalization.. · Lymphadenopathy nearly doubles mortality and plays an important prognostic role.. CITATION FORMAT · Bucher AM, Sieren M, Meinel F et al. Prevalence and prognostic role of thoracic lymphadenopathy in Covid-19. Fortschr Röntgenstr 2024; DOI: 10.1055/a-2293-8132.
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Affiliation(s)
- Andreas Michael Bucher
- Institute for Diagnostic and Interventional Radiology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Malte M Sieren
- Department of Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein Campus Lübeck, Lübeck, Germany
- Institute for Interventional Radiology, University Hospital Schleswig-Holstein Campus Lübeck, Lübeck, Germany
| | - Felix G Meinel
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Rostock, Germany
| | - Roman Kloeckner
- Institute for Interventional Radiology, University Hospital Schleswig-Holstein Campus Lübeck, Lübeck, Germany
| | - Matthias A Fink
- Institute for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Germany
| | | | - Andreas Wienke
- Institute of Medical Epidemiology, Biometry and Informatics, Martin Luther University Halle Wittenberg, Halle, Germany
| | - Hans-Jonas Meyer
- Diagnostic and Interventional Radiology, Universitätsklinikum Leipzig, Germany
| | - Tobias Penzkofer
- Department of Radiology, Charite University Hospital Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
| | - Julia Dietz
- Institute for Diagnostic and Interventional Radiology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Thomas J Vogl
- Institute for Diagnostic and Interventional Radiology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Jan Borggrefe
- University Institute of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling Hospital Minden, Germany
| | - Alexey Surov
- University Institute of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling Hospital Minden, Germany
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Bucher AM, Henzel K, Meyer HJ, Ehrengut C, Müller L, Schramm D, Akinina A, Drechsel M, Kloeckner R, Isfort P, Sähn MJ, Fink M, More D, Melekh B, Meinel FG, Dreger F, May M, Siegler L, Münzfeld H, Ruppel R, Penzkofer T, Kim MS, Balzer M, Borggrefe J, Surov A. Pericardial Effusion Predicts Clinical Outcomes in Patients with COVID-19: A Nationwide Multicenter Study. Acad Radiol 2024; 31:1784-1791. [PMID: 38155024 DOI: 10.1016/j.acra.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/25/2023] [Accepted: 12/01/2023] [Indexed: 12/30/2023]
Abstract
RATIONALE AND OBJECTIVES The prognostic role of pericardial effusion (PE) in Covid 19 is unclear. The aim of the present study was to estimate the prognostic role of PE in patients with Covid 19 in a large multicentre setting. MATERIALS AND METHODS This retrospective study is a part of the German multicenter project RACOON (Radiological Cooperative Network of the Covid 19 pandemic). The acquired sample comprises 1197 patients, 363 (30.3%) women and 834 (69.7%) men. In every case, chest computed tomography was analyzed for PE. Data about 30-day mortality, need for mechanical ventilation and need for intensive care unit (ICU) admission were collected. Data were evaluated by means of descriptive statistics. Group differences were calculated with Mann-Whitney test and Fisher exact test. Uni-and multivariable regression analyses were performed. RESULTS Overall, 46.4% of the patients were admitted to ICU, mechanical lung ventilation was performed in 26.6% and 30-day mortality was 24%. PE was identified in 159 patients (13.3%). The presence of PE was associated with 30-day mortality: HR= 1.54, CI 95% (1.05; 2.23), p = 0.02 (univariable analysis), and HR= 1.60, CI 95% (1.03; 2.48), p = 0.03 (multivariable analysis). Furthermore, density of PE was associated with the need for intubation (OR=1.02, CI 95% (1.003; 1.05), p = 0.03) and the need for ICU admission (OR=1.03, CI 95% (1.005; 1.05), p = 0.01) in univariable regression analysis. The presence of PE was associated with 30-day mortality in male patients, HR= 1.56, CI 95%(1.01-2.43), p = 0.04 (multivariable analysis). In female patients, none of PE values predicted clinical outcomes. CONCLUSION The prevalence of PE in Covid 19 is 13.3%. PE is an independent predictor of 30-day mortality in male patients with Covid 19. In female patients, PE plays no predictive role.
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Affiliation(s)
- Andreas Michael Bucher
- Institute of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfut, Germany (A.M.B., K.H.)
| | - Kristina Henzel
- Institute of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfut, Germany (A.M.B., K.H.)
| | - Hans Jonas Meyer
- Department of Radiology, University Hospital of Leipzig, Leipzig, Germany (H.J.M., C.E.)
| | - Constantin Ehrengut
- Department of Radiology, University Hospital of Leipzig, Leipzig, Germany (H.J.M., C.E.)
| | - Lukas Müller
- Department of Diagnostic and Interventional Radiology, University Medical Center Mainz, Mainz, Germany (L.M.)
| | - Dominik Schramm
- Department of Radiology University Hospital of Halle, Halle, Germany (D.S., A.A., M.D.)
| | - Alena Akinina
- Department of Radiology University Hospital of Halle, Halle, Germany (D.S., A.A., M.D.)
| | - Michelle Drechsel
- Department of Radiology University Hospital of Halle, Halle, Germany (D.S., A.A., M.D.)
| | - Roman Kloeckner
- Department of Radiology University Hospital Schleswig-Holstein-Campus Luebeck, Luebeck, Germany (R.K.)
| | - Peter Isfort
- Department of Radiology University Hospital of Aachen, Aachen, Germany (P.I., M.J.S.)
| | - Marwin-Jonathan Sähn
- Department of Radiology University Hospital of Aachen, Aachen, Germany (P.I., M.J.S.)
| | - Matthias Fink
- Clinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany (M.F., D.M.)
| | - Dorottya More
- Clinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany (M.F., D.M.)
| | - Bohdan Melekh
- Department of Radiology and Nuclear Medicine, University Hospital of Magdeburg, Magdeburg, Germany (B.M., A.S.)
| | - Felix G Meinel
- Department of Radiology University Hospital of Rostock, Rostock, Germany (F.G.M., F.D.)
| | - Franziska Dreger
- Department of Radiology University Hospital of Rostock, Rostock, Germany (F.G.M., F.D.)
| | - Matthias May
- Department of Radiology University Hospital of Erlangen, Erlangen, Germany (M.M., L.S.)
| | - Lisa Siegler
- Department of Radiology University Hospital of Erlangen, Erlangen, Germany (M.M., L.S.)
| | - Hanna Münzfeld
- Department of Radiology University Hospital of Berlin, Berlin, Germany (H.M., R.R., T.P.)
| | - Richard Ruppel
- Department of Radiology University Hospital of Berlin, Berlin, Germany (H.M., R.R., T.P.)
| | - Tobias Penzkofer
- Department of Radiology University Hospital of Berlin, Berlin, Germany (H.M., R.R., T.P.)
| | - Moon-Sung Kim
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany (M.S.K., B.M.)
| | - Miriam Balzer
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany (M.S.K., B.M.)
| | - Jan Borggrefe
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr-University-Bochum, Bochum, Germany (J.B., A.S.)
| | - Alexey Surov
- Department of Radiology and Nuclear Medicine, University Hospital of Magdeburg, Magdeburg, Germany (B.M., A.S.); Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr-University-Bochum, Bochum, Germany (J.B., A.S.).
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3
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Ahmadinejad N, Ayyoubzadeh SM, Zeinalkhani F, Delazar S, Javanmard Z, Ahmadinejad Z, Mohajeri A, Esmaeili M. Discovering associations between radiological features and COVID-19 patients' deterioration. Health Sci Rep 2023; 6:e1257. [PMID: 37711676 PMCID: PMC10497911 DOI: 10.1002/hsr2.1257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/17/2023] [Accepted: 04/23/2023] [Indexed: 09/16/2023] Open
Abstract
Background and Aims Data mining methods are effective and well-known tools for developing predictive models and extracting useful information from various data of patients. The present study aimed to predict the severity of patients with COVID-19 by applying the rule mining method using characteristics of medical images. Methods This retrospective study has analyzed the radiological data from 104 COVID-19 hospitalized patients diagnosed with COVID-19 in a hospital in Iran. A data set containing 75 binary features was generated. Apriori method is utilized for association rule mining on this data set. Only rules with confidence equal to one were generated. The performance of rules is calculated by support, coverage, and lift indexes. Results Ten rules were extracted with only X-ray-related features on cases referred to ICU. The Support and Coverage index of all of these rules was 0.087, and the Lift index of them was 1.58. Thirteen rules were extracted from only CT scan-related features on cases referred to ICU. The CXR_Pleural effusion feature has appeared in all the rules. The CXR_Left upper zone feature appears in 9 rules out of 10. The Support and Coverage index of all rules was 0.15, and the Lift index of all rules was 1.63. the CT_Adjacent pleura thickening feature has appeared in all rules, and the CT_Right middle lobe appeared in 9 rules out of 13. Conclusion This study could reveal the application and efficacy of CXR and CT scan imaging modalities in predicting ICU admission to a major COVID-19 infection via data mining methods. The findings of this study could help data scientists, radiologists, and clinicians in the future development and implementation of these methods in similar conditions and timely and appropriately save patients from adverse disease outcomes.
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Affiliation(s)
- Nasrin Ahmadinejad
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR)Tehran University of Medical SciencesTehranIran
- Radiology Department, Cancer Institute, Imam Khomeini Hospital ComplexTehran University of Medical ScienceTehranIran
| | - Seyed Mohammad Ayyoubzadeh
- Department of Health Information Management, School of Allied Medical SciencesTehran University of Medical SciencesTehranIran
| | - Fahimeh Zeinalkhani
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR)Tehran University of Medical SciencesTehranIran
- Radiology Department, Cancer Institute, Imam Khomeini Hospital ComplexTehran University of Medical ScienceTehranIran
| | - Sina Delazar
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR)Tehran University of Medical SciencesTehranIran
| | - Zohreh Javanmard
- Department of Health Information Management, School of Allied Medical SciencesTehran University of Medical SciencesTehranIran
| | - Zahra Ahmadinejad
- Department of Infectious Diseases, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
| | | | - Marzieh Esmaeili
- Department of Health Information Management, School of Allied Medical SciencesTehran University of Medical SciencesTehranIran
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Calandriello L, De Lorenzis E, Cicchetti G, D'Abronzo R, Infante A, Castaldo F, Del Ciello A, Farchione A, Gremese E, Marano R, Natale L, D'Agostino MA, Bosello SL, Larici AR. Extension of Lung Damage at Chest Computed Tomography in Severely Ill COVID-19 Patients Treated with Interleukin-6 Receptor Blockers Correlates with Inflammatory Cytokines Production and Prognosis. Tomography 2023; 9:981-994. [PMID: 37218940 DOI: 10.3390/tomography9030080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 04/27/2023] [Accepted: 04/30/2023] [Indexed: 05/24/2023] Open
Abstract
Elevated inflammatory markers are associated with severe coronavirus disease 2019 (COVID-19), and some patients benefit from Interleukin (IL)-6 pathway inhibitors. Different chest computed tomography (CT) scoring systems have shown a prognostic value in COVID-19, but not specifically in anti-IL-6-treated patients at high risk of respiratory failure. We aimed to explore the relationship between baseline CT findings and inflammatory conditions and to evaluate the prognostic value of chest CT scores and laboratory findings in COVID-19 patients specifically treated with anti-IL-6. Baseline CT lung involvement was assessed in 51 hospitalized COVID-19 patients naive to glucocorticoids and other immunosuppressants using four CT scoring systems. CT data were correlated with systemic inflammation and 30-day prognosis after anti-IL-6 treatment. All the considered CT scores showed a negative correlation with pulmonary function and a positive one with C-reactive protein (CRP), IL-6, IL-8, and Tumor Necrosis Factor α (TNF-α) serum levels. All the performed scores were prognostic factors, but the disease extension assessed by the six-lung-zone CT score (S24) was the only independently associated with intensive care unit (ICU) admission (p = 0.04). In conclusion, CT involvement correlates with laboratory inflammation markers and is an independent prognostic factor in COVID-19 patients representing a further tool to implement prognostic stratification in hospitalized patients.
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Affiliation(s)
- Lucio Calandriello
- Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, Diagnostic Imaging Area, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, L.go Agostino Gemelli 8, 00168 Rome, Italy
| | - Enrico De Lorenzis
- Unit of Rheumatology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, L.go Agostino Gemelli 8, 00168 Rome, Italy
| | - Giuseppe Cicchetti
- Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, Diagnostic Imaging Area, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, L.go Agostino Gemelli 8, 00168 Rome, Italy
| | - Rosa D'Abronzo
- Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, Diagnostic Imaging Area, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, L.go Agostino Gemelli 8, 00168 Rome, Italy
| | - Amato Infante
- Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, Diagnostic Imaging Area, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, L.go Agostino Gemelli 8, 00168 Rome, Italy
| | - Federico Castaldo
- Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, Diagnostic Imaging Area, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, L.go Agostino Gemelli 8, 00168 Rome, Italy
| | - Annemilia Del Ciello
- Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, Diagnostic Imaging Area, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, L.go Agostino Gemelli 8, 00168 Rome, Italy
| | - Alessandra Farchione
- Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, Diagnostic Imaging Area, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, L.go Agostino Gemelli 8, 00168 Rome, Italy
| | - Elisa Gremese
- Division of Clinical Immunology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, L.go Agostino Gemelli 8, 00168 Rome, Italy
- Department of Geriatric and Orthopaedic Sciences, Università Cattolica del Sacro Cuore, L.go Francesco Vito 1, 00168 Rome, Italy
| | - Riccardo Marano
- Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, Diagnostic Imaging Area, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, L.go Agostino Gemelli 8, 00168 Rome, Italy
- Department of Radiological and Hematological Sciences, Section of Radiology, Università Cattolica del Sacro Cuore, L.go Francesco Vito 1, 00168 Rome, Italy
| | - Luigi Natale
- Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, Diagnostic Imaging Area, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, L.go Agostino Gemelli 8, 00168 Rome, Italy
- Department of Radiological and Hematological Sciences, Section of Radiology, Università Cattolica del Sacro Cuore, L.go Francesco Vito 1, 00168 Rome, Italy
| | - Maria Antonietta D'Agostino
- Unit of Rheumatology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, L.go Agostino Gemelli 8, 00168 Rome, Italy
- Department of Geriatric and Orthopaedic Sciences, Università Cattolica del Sacro Cuore, L.go Francesco Vito 1, 00168 Rome, Italy
| | - Silvia Laura Bosello
- Unit of Rheumatology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, L.go Agostino Gemelli 8, 00168 Rome, Italy
- Department of Geriatric and Orthopaedic Sciences, Università Cattolica del Sacro Cuore, L.go Francesco Vito 1, 00168 Rome, Italy
| | - Anna Rita Larici
- Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, Diagnostic Imaging Area, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, L.go Agostino Gemelli 8, 00168 Rome, Italy
- Department of Radiological and Hematological Sciences, Section of Radiology, Università Cattolica del Sacro Cuore, L.go Francesco Vito 1, 00168 Rome, Italy
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Mir M, Boike S, Benedict T, Olson H, Jama AB, Anwer U, Khan SA. The Role of Computed Tomography in the Management of Hospitalized Patients With COVID-19. Cureus 2023; 15:e36821. [PMID: 37123712 PMCID: PMC10139731 DOI: 10.7759/cureus.36821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2023] [Indexed: 03/30/2023] Open
Abstract
The emergence of SARS-CoV-2 at the end of 2019 sparked the beginning of the COVID-19 pandemic. Even though it was a novel virus, the workup of suspected COVID-19 included standard protocols used for the investigation of similar respiratory infections and pneumonia. One of the most important diagnostic tests in this regard is computed tomography (CT). CT scans have a high sensitivity in diagnosing COVID-19, and many of the characteristic imaging findings of COVID-19 are used in its diagnosis. The role of CT in COVID-19 management is expanding as more and more hospital practices adopt regular CT use in both the initial workup and continued care of COVID-19 patients. CT has helped hospitalists diagnose complications such as pulmonary embolism, subcutaneous emphysema, pneumomediastinum, pneumothoraces, and nosocomial pneumonia. Although mainly used as a diagnostic tool, the prognostic role of CT in COVID-19 patients is developing. In this review, we explore the role of CT in the management of hospitalized patients with COVID-19, specifically elucidating its use as a diagnostic and prognostic modality, as well as its ability to guide hospital decision-making regarding complex cases. We will highlight important time points when CT scans are used: the initial encounter, the time at admission, and during hospitalization.
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Azizi H, Karimi H, Kazemi M, Rezaei SS, Parsaei A, Aghaali M, Vafaeimanesh J, Torabi P, Amini B, Masoumi M. COVID-19 in Patients with Rheumatic Disease Using Immunomodulatory Drugs: Imaging Findings and Predictors of Hospitalization. Rheumatol Ther 2023; 10:249-259. [PMID: 36475037 PMCID: PMC9716495 DOI: 10.1007/s40744-022-00508-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 11/03/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction SARS-CoV-2 causes more severe symptoms in most chronic diseases, and rheumatic disease is no exception. This study aims to investigate whether there is an association between the use of immunomodulatory medications, including conventional disease-modifying agents (csDMARDs), glucocorticoids, and biologic DMARDs, and outcomes such as hospitalization and lung involvement in patients with rheumatic disease with COVID-19. Methods We performed a cross-sectional study on 177 COVID-19 cases with rheumatologic diseases using immunomodulatory drugs as their regular treatment. All patients were evaluated regarding their initial chest computed tomography (CT) scan, COVID-19 symptoms, and comorbidities. We ran predictive models to find variables associated with chest CT-scan involvement and hospitalization status. Results CT findings showed lung involvement in 87 patients with chest CT-scan severity score (C-ss) of less than 8 in 59 (33%) and more than 8 in 28 (16%) of our patients. Of all patients, 76 (43%) were hospitalized. Hospitalized patients were significantly older and had more comorbidities (P = 0.02). On multivariate analysis, older age [odds ratio (OR) 1.90, 95% confidence interval (CI) 1.31-3.08] and comorbidity (OR 2.75, 95% CI 1.06-3.66) were significantly associated with higher odds of hospitalization (P = 0.03). On multivariate analysis, older age (OR 1.15, 95% CI 0.94-2.01), pulmonary diseases (OR 2.05, 95% CI 1.18-3.32), and treatment with csDMARDs (OR 1.88, 95% CI 0.37-1.93) were associated with higher C-ss (P = 0.039). Conclusions This study found that advanced age and comorbidities, similar to the general population, are risk factors for hospitalization in patients with COVID-19 with rheumatic disorders. Administration of csDMARDs, older age, and pulmonary disorders were linked to increased risk of COVID-19 pneumonia in these individuals.
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Affiliation(s)
- Hossein Azizi
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Hanie Karimi
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Kazemi
- Clinical Research of Development Center, Shahid Beheshti Hospital, Qom University of Medical Sciences, Beheshti Blvd, Qom, Iran
| | - Somaye Sadat Rezaei
- Clinical Research of Development Center, Shahid Beheshti Hospital, Qom University of Medical Sciences, Beheshti Blvd, Qom, Iran
| | | | - Mohammad Aghaali
- Department of Community Medicine, School of Medicine, Qom University of Medical Sciences, Qom, Iran
| | - Jamshid Vafaeimanesh
- Department of Internal Medicine, School of Medicine, Qom University of Medical Sciences, Qom, Iran
| | - Pouya Torabi
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnam Amini
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Masoumi
- Clinical Research of Development Center, Shahid Beheshti Hospital, Qom University of Medical Sciences, Beheshti Blvd, Qom, Iran
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Muacevic A, Adler JR, Bousgheiri F, Belafki H, Gourinda A, Sammoud K, Salmane F, Ftouh W, Benkacem M, Najdi A. Predictive Factors of Death and the Clinical Profile of Hospitalized Covid-19 Patients in Morocco: A One-Year Mixed Cohort Study. Cureus 2022; 14:e32462. [PMID: 36644046 PMCID: PMC9835847 DOI: 10.7759/cureus.32462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2022] [Indexed: 12/15/2022] Open
Abstract
Background Since the onset of the Covid-19 pandemic, several studies have been conducted around the world in an attempt to understand this heterogeneous and unpredictable disease and to prevent related death. It was therefore necessary to study the associated risk factors of Covid-19-related mortality. Objectives The aim of this study was to describe the clinical profile and to identify the factors associated with mortality of patients with Covid-19 in Morocco. Methods We performed a mixed cohort study (retrospective and prospective) of 615 in-patients with Covid-19 disease, enrolled between August 2020 and October 2021. We followed the cohort throughout the hospitalization until discharge and 30 days thereafter. Results The median age was 64 years old; 62.1% of the patients were male. The mean time from symptom onset to hospitalization was 8.5 days (±4.67), and 68.1% of patients had comorbidities. On admission, the most common symptoms were dyspnea (82.2%), cough (80.3%), and fever (76.8%). The main follow-up complication was secondary infection (56.9%). Based on univariate analysis, male gender (p<0.008 and brut relative risk {bRR}=1.57), advanced age (p<0.001), lung involvement (p<0.001), lymphopenia (p<0.001 and bRR=2.32), D-dimers of >500 µg/l (p<0.007 and bRR=2.47), C-reactive protein (CRP) of >130 mg/l (p<0.001 and bRR=2.45), elevated creatinine (p<0.013 and bRR=1.61), lactate dehydrogenase (LDH) of >500 U/l (p<0.001 and bRR=7.16), receiving corticosteroids (p<0.001 and bRR=5.08), invasive ventilation (p<0.001 and bRR=30.10), the stay in the resuscitation unit (p<0.001 and bRR=13.37), and acute respiratory distress syndrome (ARDS) (p<0.001 and bRR=10.98) were associated with a higher risk of death. In the opposite, receiving azithromycin and hydroxychloroquine (p<0.001 and bRR=0.28) and pre-admission anticoagulants (p<0.005 and bRR=0.46) was associated with a lower risk of mortality. Multivariate regression analysis showed that age of >60 years (p<0.001 and adjusted odds ratio {aOR}=4.90), the use of invasive ventilation (p<0.001 and aOR=9.60), the stay in the resuscitation unit (p<0.001 and aOR=5.09), and acute respiratory distress syndrome (p<0.001 and aOR=6.49) were independent predictors of Covid-19 mortality. Conclusion In this cohort study focusing on Covid-19 in-patient's mortality, we found that age of >60 years, the use of invasive ventilation, the stay in the resuscitation unit, and acute respiratory distress syndrome were independent predictors of Covid-19 mortality. The results of this study can be used to improve knowledge for better clinical management of Covid-19 in-patients.
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Muzoğlu N, Halefoğlu AM, Avci MO, Kaya Karaaslan M, Yarman BSB. Detection of COVID-19 and its pulmonary stage using Bayesian hyperparameter optimization and deep feature selection methods. EXPERT SYSTEMS 2022; 40:e13141. [PMID: 36245832 PMCID: PMC9537791 DOI: 10.1111/exsy.13141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 07/25/2022] [Accepted: 09/05/2022] [Indexed: 06/16/2023]
Abstract
Since the first case of COVID-19 was reported in December 2019, many studies have been carried out on artificial intelligence for the rapid diagnosis of the disease to support health services. Therefore, in this study, we present a powerful approach to detect COVID-19 and COVID-19 findings from computed tomography images using pre-trained models using two different datasets. COVID-19, influenza A (H1N1) pneumonia, bacterial pneumonia and healthy lung image classes were used in the first dataset. Consolidation, crazy-paving pattern, ground-glass opacity, ground-glass opacity and consolidation, ground-glass opacity and nodule classes were used in the second dataset. The study consists of four steps. In the first two steps, distinctive features were extracted from the final layers of the pre-trained ShuffleNet, GoogLeNet and MobileNetV2 models trained with the datasets. In the next steps, the most relevant features were selected from the models using the Sine-Cosine optimization algorithm. Then, the hyperparameters of the Support Vector Machines were optimized with the Bayesian optimization algorithm and used to reclassify the feature subset that achieved the highest accuracy in the third step. The overall accuracy obtained for the first and second datasets is 99.46% and 99.82%, respectively. Finally, the performance of the results visualized with Occlusion Sensitivity Maps was compared with Gradient-weighted class activation mapping. The approach proposed in this paper outperformed other methods in detecting COVID-19 from multiclass viral pneumonia. Moreover, detecting the stages of COVID-19 in the lungs was an innovative and successful approach.
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Affiliation(s)
- Nedim Muzoğlu
- Department of Biomedical Engineering, Faculty of EngineeringIstanbul University‐CerrahpasaIstanbulTurkey
| | - Ahmet Mesrur Halefoğlu
- Department of RadiologySisli Hamidiye Etfal Training and Research Hospital, Health Sciences UniversityIstanbulTurkey
| | - Muhammed Onur Avci
- Department of Biomedical Engineering, Faculty of EngineeringIstanbul University‐CerrahpasaIstanbulTurkey
| | - Melike Kaya Karaaslan
- Department of Biomedical SciencesFaculty of Engineering, Kocaeli UniversityKocaeliTurkey
| | - Bekir Sıddık Binboğa Yarman
- Department of Electrical‐Electronics Engineering, Faculty of EngineeringIstanbul University‐CerrahpasaIstanbulTurkey
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Wang Y, Nan L, Hu M, Zhang R, Hao Y, Wang Y, Yang H. Significant association between anemia and higher risk for COVID-19 mortality: A meta-analysis of adjusted effect estimates. Am J Emerg Med 2022; 58:281-285. [PMID: 35753290 PMCID: PMC9217068 DOI: 10.1016/j.ajem.2022.06.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate whether there was a significant relationship between anemia and the risk for mortality among coronavirus disease 2019 (COVID-19) patients by a quantitative meta-analysis based on the adjusted effect estimates. METHODS A systematic search was conducted in electronic databases to identify all published literature. A random-effects meta-analysis model was used to estimate the pooled effect size and 95% confidence interval (CI). Heterogeneity test, Begg's test, subgroup analysis and meta-regression were performed. RESULTS Twenty-three articles with 573,928 COVID-19 patients were included in the quantitative meta-analysis. There was a significant association between anemia and an elevated risk of COVID-19 mortality (pooled effect size = 1.47, 95% CI [1.30-1.67]). We observed this significant association in the further subgroup analyses by age, proportion of males, sample size, study design, region and setting. Sensitivity analysis exhibited that our results were reliable. Begg's test showed that there was no publication bias. Meta-regression indicated that the tested variables might not be the source of heterogeneity. CONCLUSION Our meta-analysis based on risk factors-adjusted effect estimates indicated that anemia was independently associated with a significantly elevated risk for mortality among COVID-19 patients.
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Affiliation(s)
- Ying Wang
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Lan Nan
- Yusuf Hamied Department of Chemistry, University of Cambridge, UK
| | - Mengke Hu
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Ruiying Zhang
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Yuqing Hao
- International College of Zhengzhou University, Zhengzhou 450052, China
| | - Yadong Wang
- Department of Toxicology, Henan, Center for Disease Control and Prevention, Zhengzhou 450016, China
| | - Haiyan Yang
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou 450001, China.
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Zakariaee SS, Salmanipour H, Naderi N, Kazemi-Arpanahi H, Shanbehzadeh M. Association of chest CT severity score with mortality of COVID-19 patients: a systematic review and meta-analysis. Clin Transl Imaging 2022; 10:663-676. [PMID: 35892066 PMCID: PMC9302953 DOI: 10.1007/s40336-022-00512-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/05/2022] [Indexed: 01/08/2023]
Abstract
Purpose Chest computed tomography (CT) is a high-sensitivity diagnostic tool for depicting interstitial pneumonia and may lay a critical role in the evaluation of the severity and extent of pulmonary involvement. In this study, we aimed to evaluate the association of chest CT severity score (CT-SS) with the mortality of COVID-19 patients using systematic review and meta-analysis. Methods Web of Science, PubMed, Embase, Scopus, and Google Scholar were used to search for primary articles. The meta-analysis was performed using the random-effects model, and odds ratios (ORs) with 95% confidence intervals (95%CIs) were calculated as the effect sizes. Results This meta-analysis retrieved a total number of 7106 COVID-19 patients. The pooled estimate for the association of CT-SS with mortality of COVID-19 patients was calculated as 1.244 (95% CI 1.157–1.337). The pooled estimate for the association of CT-SS with an optimal cutoff and mortality of COVID-19 patients was calculated as 7.124 (95% CI 5.307–9.563). There was no publication bias in the results of included studies. Radiologist experiences and study locations were not potential sources of between-study heterogeneity (both P > 0.2). The shapes of Begg’s funnel plots seemed symmetrical for studies evaluating the association of CT-SS with/without the optimal cutoffs and mortality of COVID-19 patients (Begg’s test P = 0.945 and 0.356, respectively). Conclusions The results of this study point to an association between CT-SS and mortality of COVID-19 patients. The odds of mortality for COVID-19 patients could be accurately predicted using an optimal CT-SS cutoff in visual scoring of lung involvement.
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Affiliation(s)
- Seyed Salman Zakariaee
- Department of Medical Physics, Faculty of Paramedical Sciences, Ilam University of Medical Sciences, Ilam, Iran
| | - Hossein Salmanipour
- Department of Radiology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Negar Naderi
- Department of Midwifery, Faculty of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran
| | - Hadi Kazemi-Arpanahi
- Department of Health Information Technology, School of Management and Medical Information Sciences, Abadan University of Medical Sciences, Abadan, Iran
| | - Mostafa Shanbehzadeh
- Department of Health Information Technology, School of Paramedical Sciences, Ilam University of Medical Sciences, Ilam, Iran
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Kavosi H, Nayebi Rad S, Atef Yekta R, Tamartash Z, Dini M, Javadi Nejad Z, Aghaghazvini L, Javinani A, Mohammadzadegan AM, Fotook Kiaei SZ. Cardiopulmonary predictors of mortality in patients with COVID-19: What are the findings? Arch Cardiovasc Dis 2022; 115:388-396. [PMID: 35752584 PMCID: PMC9174274 DOI: 10.1016/j.acvd.2022.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 04/06/2022] [Accepted: 04/11/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Since 2019, coronavirus disease 2019 (COVID-19) has been the leading cause of mortality worldwide. AIMS To determine independent predictors of mortality in COVID-19, and identify any associations between pulmonary disease severity and cardiac involvement. METHODS Clinical, laboratory, electrocardiography and computed tomography (CT) imaging data were collected from 389 consecutive patients with COVID-19. Patients were divided into alive and deceased groups. Independent predictors of mortality were identified. Kaplan-Meier analysis was performed, based on patients having a troponin concentration>99th percentile (cardiac injury) and a CT severity score ≥18. RESULTS The mortality rate was 29.3%. Cardiac injury (odds ratio [OR] 2.19, 95% confidence interval [CI] 1.14-4.18; P=0.018), CT score ≥18 (OR 2.24, 95% CI 1.15-4.34; P=0.017), localized ST depression (OR 3.77, 95% CI 1.33-10.67; P=0.012), hemiblocks (OR 3.09, 95% CI 1.47-6.48; P=0.003) and history of leukaemia/lymphoma (OR 3.76, 95% CI 1.37-10.29; P=0.010) were identified as independent predictors of mortality. Additionally, patients with cardiac injury and CT score ≥ 18 were identified to have a significantly shorter survival time (mean 14.21 days, 95% CI 10.45-17.98 days) than all other subgroups. There were no associations between CT severity score and electrocardiogram or cardiac injury in our results. CONCLUSIONS Our findings suggest that using CT imaging and electrocardiogram characteristics together can provide a better means of predicting mortality in patients with COVID-19. We identified cardiac injury, CT score ≥18, presence of left or right hemiblocks on initial electrocardiogram, localized ST depression and history of haematological malignancies as independent predictors of mortality in patients with COVID-19.
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Affiliation(s)
- Hoda Kavosi
- Rheumatology Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Sepehr Nayebi Rad
- Students' Scientific Research Centre (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Atef Yekta
- Department of Anaesthesiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Tamartash
- Rheumatology Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahboubeh Dini
- Non-Communicable Disease Centre, Ministry of Health and Medical Education, Tehran, Iran
| | - Zahra Javadi Nejad
- Rheumatology Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Aghaghazvini
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Javinani
- Rheumatology Research Centre, Tehran University of Medical Sciences, Tehran, Iran
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Zakariaee SS, Abdi AI. Influence of threshold selection strategy on the prognostic accuracy of chest CT severity score for mortality prediction of COVID-19 patients. Heart Lung 2022; 56:74-75. [PMID: 35792344 PMCID: PMC9236912 DOI: 10.1016/j.hrtlng.2022.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 06/23/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Seyed Salman Zakariaee
- Department of Medical Physics, Faculty of Paramedical Sciences, Ilam University of Medical Sciences, Ilam, Iran.
| | - Aza Ismail Abdi
- Department of Radiology, Erbil Medical Technical Institute, Erbil Polytechnic University, Erbil, Iraq
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Yanamandra U, Shobhit S, Paul D, Aggarwal B, Kaur P, Duhan G, Singh A, Srinath R, Saxena P, Menon AS. Relationship of Computed Tomography Severity Score With Patient Characteristics and Survival in Hypoxemic COVID-19 Patients. Cureus 2022; 14:e22847. [PMID: 35382199 PMCID: PMC8977105 DOI: 10.7759/cureus.22847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2022] [Indexed: 12/14/2022] Open
Abstract
Background Computed tomography (CT) scans and CT severity scores (CTSS) are widely used to assess the severity and prognosis in coronavirus disease 2019 (COVID-19). CTSS has performed well as a predictor in differentiating severe from non-severe cases. However, it is not known if CTSS performs similarly in hospitalized severe cases with hypoxia at admission. Methods We conducted a retrospective comparative study at a COVID-care center from Western India between 25th April and 31st May 2021, enrolling all consecutive severe COVID-19 patients with hypoxemia (peripheral oxygen saturation < 94%). Neutrophil-lymphocyte ratio (NLR), C-reactive protein (CRP), interleukin-6 (IL-6), lactate dehydrogenase (LDH), D-dimer, ferritin, and CT thorax were done within 24h of admission before being initiated on any anti-COVID-19 therapy. CTSS was calculated by visual assessment and categorized into three severity categories and was correlated with laboratory markers and overall survival (OS). Statistical analysis was done using John's Macintosh Project (JMP) 15.0.0 ver. 3.0.0 (Cary, North Carolina). Results The median age of the study population (n-298) was 59 years (24-95) with a male preponderance (61.41%, n=183). The 15 and 30-day survivals were 67.64% and 59.90%, respectively. CTSS did not correlate with age, gender, time from vaccination, symptoms, or comorbidities but had a significant though weak correlation with LDH (p=0.009), D-dimer (p=0.006), and NLR (p=0.019). Comparing demographic and laboratory aspects using CT severity categories, only NLR (p=0.0146) and D-dimer (p=0.0006) had significant differences. The 15d-OS of mild, moderate, and severe CT categories were 88.62%, 70.39%, and 52.62%, respectively, while 30d-OS of three categories were 59.08%, 63.96%, and 49.12%, respectively. Conclusion Among hospitalized severe COVID-19 patients with hypoxemia at admission, CT severity categories correlate well with outcomes but not inflammatory markers at admission.
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Luo H, Wang Y, Liu S, Chen R, Chen T, Yang Y, Wang D, Ju S. Associations between CT pulmonary opacity score on admission and clinical characteristics and outcomes in patients with COVID-19. Intern Emerg Med 2022; 17:153-163. [PMID: 34191219 PMCID: PMC8243308 DOI: 10.1007/s11739-021-02795-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 06/10/2021] [Indexed: 12/12/2022]
Abstract
This study investigated associations between chest computed tomography (CT) pulmonary opacity score on admission and clinical features and outcomes in COVID-19 patients. The retrospective multi-center cohort study included 496 COVID-19 patients in Jiangsu province, China diagnosed as of March 15, 2020. Patients were divided into four groups based on the quartile of pulmonary opacity score: ≤ 5%, 6-20%, 21-40% and 41% +. CT pulmonary opacity score was independently associated with age, single onset, fever, cough, peripheral capillary oxygen saturation, lymphocyte count, platelet count, albumin level, C-reactive protein (CRP) level and fibrinogen level on admission. Patients with score ≥ 41% had a dramatic increased risk of severe or critical illness [odds ratio (OR), 15.58, 95% confidence interval (CI) 3.82-63.53), intensive care unit (ICU)] admission (OR, 6.26, 95% CI 2.15-18.23), respiratory failure (OR, 19.49, 95% CI 4.55-83.40), and a prolonged hospital stay (coefficient, 2.59, 95% CI 0.46-4.72) compared to those with score ≤ 5%. CT pulmonary opacity score on admission, especially when ≥ 41%, was closely related to some clinical characteristics and was an independent predictor of disease severity, ICU admission, respiratory failure and long hospital stay in patients with COVID-19.
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Affiliation(s)
- Huanyuan Luo
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Yuancheng Wang
- Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, China
| | - Songqiao Liu
- Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, China
| | - Ruoling Chen
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, WV1 1LY, UK
| | - Tao Chen
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Yi Yang
- Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, China
| | - Duolao Wang
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK.
| | - Shenghong Ju
- Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, China.
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Meyer HJ, Wienke A, Surov A. Extrapulmonary CT Findings Predict In-Hospital Mortality in COVID-19. A Systematic Review and Meta-Analysis. Acad Radiol 2022; 29:17-30. [PMID: 34772618 PMCID: PMC8516661 DOI: 10.1016/j.acra.2021.10.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/05/2021] [Accepted: 10/05/2021] [Indexed: 12/15/2022]
Abstract
RATIONALE AND OBJECTIVES Several prognostic factors have been identified for COVID-19 disease. Our aim was to elucidate the influence of non-pulmonary findings of thoracic computed tomography (CT) on unfavorable outcomes and in-hospital mortality in COVID-19 patients based on a large patient sample. MATERIALS AND METHODS MEDLINE library, Cochrane and SCOPUS databases were screened for the associations between CT-defined features and mortality in COVID-19 patients up to June 2021. In total, 22 studies were suitable for the analysis, and included into the present analysis. Overall, data regarding 4 extrapulmonary findings could be pooled: pleural effusion, pericardial effusion, mediastinal lymphadenopathy, and coronary calcification. RESULTS The included studies comprised 7859 patients. The pooled odds ratios for the effect of the identified extrapulmonary findings on in-hospital mortality are as follows: pleural effusion, 4.60 (95% CI 2.97-7.12); pericardial effusion, 1.29 (95% CI 0.83-1.98); coronary calcification, 2.68 (95% CI 1.78-4.04); mediastinal lymphadenopathy, 2.02 (95% CI 1.18-3.45). CONCLUSION Pleural effusion, mediastinal lymphadenopathy and coronary calcification have a relevant association with in-hospital mortality in COVID-19 patients and should be included as prognostic biomarker into clinical routine.
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Affiliation(s)
- Hans-Jonas Meyer
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, Germany.
| | - Andreas Wienke
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Alexey Surov
- Department of Radiology and Nuclear Medicine, University of Magdeburg, Magdeburg, Germany
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Salaffi F, Carotti M, Di Carlo M, Ceccarelli L, Galli M, Sarzi-Puttini P, Giovagnoni A. Predicting Severe/Critical Outcomes in Patients With SARS-CoV2 Pneumonia: Development of the prediCtion seveRe/crItical ouTcome in COVID-19 (CRITIC) Model. Front Med (Lausanne) 2021; 8:695195. [PMID: 34568363 PMCID: PMC8456023 DOI: 10.3389/fmed.2021.695195] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/12/2021] [Indexed: 01/02/2023] Open
Abstract
Objective: To create a prediction model of the risk of severe/critical disease in patients with Coronavirus disease (COVID-19). Methods: Clinical, laboratory, and lung computed tomography (CT) severity score were collected from patients admitted for COVID-19 pneumonia and considered as independent variables for the risk of severe/critical disease in a logistic regression analysis. The discriminative properties of the variables were analyzed through the area under the receiver operating characteristic curve analysis and included in a prediction model based on Fagan's nomogram to calculate the post-test probability of severe/critical disease. All analyses were conducted using Medcalc (version 19.0, MedCalc Software, Ostend, Belgium). Results: One hundred seventy-one patients with COVID-19 pneumonia, including 37 severe/critical cases (21.6%) and 134 mild/moderate cases were evaluated. Among all the analyzed variables, Charlson Comorbidity Index (CCI) was that with the highest relative importance (p = 0.0001), followed by CT severity score (p = 0.0002), and age (p = 0.0009). The optimal cut-off points for the predictive variables resulted: 3 for CCI [sensitivity 83.8%, specificity 69.6%, positive likelihood ratio (+LR) 2.76], 69.9 for age (sensitivity 94.6%, specificity 68.1, +LR 2.97), and 53 for CT severity score (sensitivity 64.9%, specificity 84.4%, +LR 4.17). Conclusion: The nomogram including CCI, age, and CT severity score, may be used to stratify patients with COVID-19 pneumonia.
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Affiliation(s)
- Fausto Salaffi
- Rheumatology Clinic, Dipartimento di Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Jesi, Italy
| | - Marina Carotti
- Dipartimento di Scienze Radiologiche Struttura Organizzativa Dipartimentale Radiologia Pediatrica e Specialistica, Azienda Ospedaliera Universitaria, Ospedali Riuniti di Ancona, Ancona, Italy
| | - Marco Di Carlo
- Rheumatology Clinic, Dipartimento di Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Jesi, Italy
| | - Luca Ceccarelli
- Unità Operativa di Radiologia – Ospedale degli Infermi, Azienda Unità Sanitaria Locale della Romagna, Faenza, Italy
| | - Massimo Galli
- Divisione di Malattie Infettive, Dipartimento di Scienze Biomediche e Cliniche “Luigi Sacco, ” Azienda Socio Sanitaria Territoriale Fatebenefratelli-Sacco, Milan University School of Medicine, Milan, Italy
| | - Piercarlo Sarzi-Puttini
- Divisione di Reumatologia, Dipartimento di Scienze Biomediche e Cliniche “Luigi Sacco, ” Azienda Socio Sanitaria Territoriale Fatebenefratelli-Sacco, Milan University School of Medicine, Milan, Italy
| | - Andrea Giovagnoni
- Dipartimento di Scienze Radiologiche Struttura Organizzativa Dipartimentale Radiologia Pediatrica e Specialistica, Azienda Ospedaliera Universitaria, Ospedali Riuniti di Ancona, Ancona, Italy
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Pulgar-Sánchez M, Chamorro K, Fors M, Mora FX, Ramírez H, Fernandez-Moreira E, Ballaz SJ. Biomarkers of severe COVID-19 pneumonia on admission using data-mining powered by common laboratory blood tests-datasets. Comput Biol Med 2021; 136:104738. [PMID: 34391001 PMCID: PMC8349478 DOI: 10.1016/j.compbiomed.2021.104738] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 07/14/2021] [Accepted: 08/02/2021] [Indexed: 12/23/2022]
Abstract
In the epidemiological COVID-19 research, artificial intelligence is a unique approach to make predictions about disease severity to manage COVID-19 patients. A limitation of artificial intelligence is, however, the high risk of bias. We investigated the skill of data mining and machine learning, two advanced forms of artificial intelligence, to predict severe COVID-19 pneumonia based on routine laboratory tests. A sample of 4009 COVID-19 patients was divided into Severe (PaO2< 60 mmHg, 489 cases) and Non-Severe (PaO2 ≥ 60 mmHg, 3520 cases) groups according to blood hypoxemia on admission and their laboratory datasets analyzed by the R software and WEKA workbench. After curation, data were processed for the selection of the most influential features including hemogram, pCO2, blood acid-base balance, prothrombin time, inflammation biomarkers, and glucose. The best fit of variables was successfully confirmed by either the Multilayer Perceptron, a feedforward neural network algorithm that performed machine recognition of severe COVID-19 with 96.5% precision, or by the C4.5 software, a supervised learning algorithm based on an objective-predefined variable (severity) that generated a decision tree with 89.4% precision. Finally, a complex bivariate Pearson's correlation matrix combined with advanced hierarchical clustering (dendrograms) were conducted for knowledge discovery. The hidden structure of the datasets revealed shift patterns related to the development of COVID-19-induced pneumonia that involved the lymphocyte-to-C-reactive protein and leukocyte-to-C-protein ratios, neutrophil %, pH and pCO2. The data mining approaches to the hematological fluctuations associated with severe COVID-19 pneumonia could not only anticipate adverse clinical outcomes, but also reveal putative therapeutic targets.
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Affiliation(s)
- Mary Pulgar-Sánchez
- Escuela de Ciencias Biológicas e Ingeniería. Universidad Yachay Tech, Urcuquí, Ecuador
| | - Kevin Chamorro
- Escuela de Matemáticas y Ciencias Computacionales. Universidad Yachay Tech, Urcuquí, Ecuador; Universidad Técnica Del Norte, Ibarra, Ecuador
| | - Martha Fors
- Escuela de Medicina; Universidad de las Américas, Quito, Ecuador
| | | | - Hégira Ramírez
- Escuela de Medicina; Universidad de las Américas, Quito, Ecuador
| | | | - Santiago J Ballaz
- Escuela de Ciencias Biológicas e Ingeniería. Universidad Yachay Tech, Urcuquí, Ecuador; Escuela de Medicina, Universidad Espíritu Santo, Samborondón, Ecuador.
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Role of Lung Ultrasound in Predicting Clinical Severity and Fatality in COVID-19 Pneumonia. J Pers Med 2021; 11:jpm11080757. [PMID: 34442401 PMCID: PMC8399683 DOI: 10.3390/jpm11080757] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/24/2021] [Accepted: 07/29/2021] [Indexed: 02/08/2023] Open
Abstract
Background: Lung ultrasound (LUS) is a useful imaging method for identifying COVID-19 pneumonia. The aim of this study was to explore the role of LUS in predicting the severity of the disease and fatality in patients with COVID-19. Methods: This was a single-center, follow-up study, conducted from 1 November 2020, to 22 March 2021. The LUS protocol was based on the assessment of 14 lung zones with a total score up to 42, which was compared to the disease severity and fatality. Results: A total of 133 patients with COVID-19 pneumonia confirmed by RT-PCR were enrolled, with a median time from hospital admission to lung ultrasound of one day. The LUS score was correlated with clinical severity at hospital admission (Spearman’s rho 0.40, 95% CI 0.24 to 0.53, p < 0.001). Patients with higher LUS scores were experiencing greater disease severity; a high flow nasal cannula had an odds ratio of 1.43 (5% CI 1.17–1.74) in patients with LUS score > 29; the same score also predicted the need for mechanical ventilation (1.25, [1.07–1.48]). An LUS score > 30 (1.41 [1.18–1.68]) and age over 68 (1.26 [1.11–1.43]) were significant predictors of fatality. Conclusions: LUS at hospital admission is shown to have a high predictive power of the severity and fatality of COVID-19 pneumonia.
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Sait U, K V GL, Shivakumar S, Kumar T, Bhaumik R, Prajapati S, Bhalla K, Chakrapani A. A deep-learning based multimodal system for Covid-19 diagnosis using breathing sounds and chest X-ray images. Appl Soft Comput 2021; 109:107522. [PMID: 34054379 PMCID: PMC8149173 DOI: 10.1016/j.asoc.2021.107522] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 04/20/2021] [Accepted: 05/21/2021] [Indexed: 12/23/2022]
Abstract
Covid-19 has become a deadly pandemic claiming more than three million lives worldwide. SARS-CoV-2 causes distinct pathomorphological alterations in the respiratory system, thereby acting as a biomarker to aid its diagnosis. A multimodal framework (Ai-CovScan) for Covid-19 detection using breathing sounds, chest X-ray (CXR) images, and rapid antigen test (RAnT) is proposed. Transfer Learning approach using existing deep-learning Convolutional Neural Network (CNN) based on Inception-v3 is combined with Multi-Layered Perceptron (MLP) to develop the CovScanNet model for reducing false-negatives. This model reports a preliminary accuracy of 80% for the breathing sound analysis, and 99.66% Covid-19 detection accuracy for the curated CXR image dataset. Based on Ai-CovScan, a smartphone app is conceptualised as a mass-deployable screening tool, which could alter the course of this pandemic. This app’s deployment could minimise the number of people accessing the limited and expensive confirmatory tests, thereby reducing the burden on the severely stressed healthcare infrastructure.
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Affiliation(s)
- Unais Sait
- Faculty of Architecture and Design, PES University, Bengaluru, India
| | - Gokul Lal K V
- East Point College of Engineering and Technology, Bengaluru, India
| | - Sanjana Shivakumar
- Department of Design and Computation Arts, Concordia University, Qc, Canada
| | - Tarun Kumar
- Centre for Product Design and Manufacturing, Indian Institute of Science, Bengaluru, India
| | - Rahul Bhaumik
- Faculty of Architecture and Design, PES University, Bengaluru, India
| | - Sunny Prajapati
- Faculty of Architecture and Design, PES University, Bengaluru, India
| | - Kriti Bhalla
- School of Architecture, Ramaiah Institute of Technology, Bengaluru, Karnataka, India
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20
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Shiri I, Sorouri M, Geramifar P, Nazari M, Abdollahi M, Salimi Y, Khosravi B, Askari D, Aghaghazvini L, Hajianfar G, Kasaeian A, Abdollahi H, Arabi H, Rahmim A, Radmard AR, Zaidi H. Machine learning-based prognostic modeling using clinical data and quantitative radiomic features from chest CT images in COVID-19 patients. Comput Biol Med 2021; 132:104304. [PMID: 33691201 PMCID: PMC7925235 DOI: 10.1016/j.compbiomed.2021.104304] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/26/2021] [Accepted: 02/27/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To develop prognostic models for survival (alive or deceased status) prediction of COVID-19 patients using clinical data (demographics and history, laboratory tests, visual scoring by radiologists) and lung/lesion radiomic features extracted from chest CT images. METHODS Overall, 152 patients were enrolled in this study protocol. These were divided into 106 training/validation and 46 test datasets (untouched during training), respectively. Radiomic features were extracted from the segmented lungs and infectious lesions separately from chest CT images. Clinical data, including patients' history and demographics, laboratory tests and radiological scores were also collected. Univariate analysis was first performed (q-value reported after false discovery rate (FDR) correction) to determine the most predictive features among all imaging and clinical data. Prognostic modeling of survival was performed using radiomic features and clinical data, separately or in combination. Maximum relevance minimum redundancy (MRMR) and XGBoost were used for feature selection and classification. The receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC), sensitivity, specificity, and accuracy were used to assess the prognostic performance of the models on the test datasets. RESULTS For clinical data, cancer comorbidity (q-value < 0.01), consciousness level (q-value < 0.05) and radiological score involved zone (q-value < 0.02) were found to have high correlated features with outcome. Oxygen saturation (AUC = 0.73, q-value < 0.01) and Blood Urea Nitrogen (AUC = 0.72, q-value = 0.72) were identified as high clinical features. For lung radiomic features, SAHGLE (AUC = 0.70) and HGLZE (AUC = 0.67) from GLSZM were identified as most prognostic features. Amongst lesion radiomic features, RLNU from GLRLM (AUC = 0.73), HGLZE from GLSZM (AUC = 0.73) had the highest performance. In multivariate analysis, combining lung, lesion and clinical features was determined to provide the most accurate prognostic model (AUC = 0.95 ± 0.029 (95%CI: 0.95-0.96), accuracy = 0.88 ± 0.046 (95% CI: 0.88-0.89), sensitivity = 0.88 ± 0.066 (95% CI = 0.87-0.9) and specificity = 0.89 ± 0.07 (95% CI = 0.87-0.9)). CONCLUSION Combination of radiomic features and clinical data can effectively predict outcome in COVID-19 patients. The developed model has significant potential for improved management of COVID-19 patients.
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Affiliation(s)
- Isaac Shiri
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, CH-1211, Geneva, Switzerland
| | - Majid Sorouri
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Parham Geramifar
- Research Center for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Nazari
- Department of Biomedical Engineering and Medical Physics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Abdollahi
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Yazdan Salimi
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, CH-1211, Geneva, Switzerland
| | - Bardia Khosravi
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Dariush Askari
- Department of Radiology Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Leila Aghaghazvini
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ghasem Hajianfar
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Amir Kasaeian
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran,Hematology, Oncology and Stem Cell Transplantation Research Center, Research Institute for Oncology, Hematology and Cell Therapy, Tehran University of Medical Sciences, Tehran, Iran,Inflammation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Abdollahi
- Department of Radiologic Sciences and Medical Physics, Kerman University of Medical Sciences, Kerman, Iran
| | - Hossein Arabi
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, CH-1211, Geneva, Switzerland
| | - Arman Rahmim
- Departments of Radiology and Physics, University of British Columbia, Vancouver, BC, Canada,Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, BC, Canada
| | - Amir Reza Radmard
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran,Corresponding author. Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Habib Zaidi
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, CH-1211, Geneva, Switzerland,Geneva University Neurocenter, Geneva University, Geneva, Switzerland,Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, Netherlands,Department of Nuclear Medicine, University of Southern Denmark, Odense, Denmark,Corresponding author. Geneva University Hospital, Division of Nuclear Medicine and Molecular Imaging, CH-1211, Geneva, Switzerland
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21
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Brogna B, Bignardi E, Brogna C, Volpe M, Lombardi G, Rosa A, Gagliardi G, Capasso PFM, Gravino E, Maio F, Pane F, Picariello V, Buono M, Colucci L, Musto LA. A Pictorial Review of the Role of Imaging in the Detection, Management, Histopathological Correlations, and Complications of COVID-19 Pneumonia. Diagnostics (Basel) 2021; 11:437. [PMID: 33806423 PMCID: PMC8000129 DOI: 10.3390/diagnostics11030437] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 02/22/2021] [Accepted: 02/27/2021] [Indexed: 02/07/2023] Open
Abstract
Imaging plays an important role in the detection of coronavirus (COVID-19) pneumonia in both managing the disease and evaluating the complications. Imaging with chest computed tomography (CT) can also have a potential predictive and prognostic role in COVID-19 patient outcomes. The aim of this pictorial review is to describe the role of imaging with chest X-ray (CXR), lung ultrasound (LUS), and CT in the diagnosis and management of COVID-19 pneumonia, the current indications, the scores proposed for each modality, the advantages/limitations of each modality and their role in detecting complications, and the histopathological correlations.
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Affiliation(s)
- Barbara Brogna
- Department of Radiology, San Giuseppe Moscati Hospital, Contrada Amoretta, 83100 Avellino, Italy; (M.V.); (G.L.); (A.R.); (G.G.); (P.F.M.C.); (E.G.); (F.M.); (F.P.); (V.P.); (M.B.); (L.C.); (L.A.M.)
| | - Elio Bignardi
- Radiology Unit, Cotugno Hospital, Naples, Via Quagliariello 54, 80131 Naples, Italy;
| | - Claudia Brogna
- Neuropsychiatric Unit ASL Avellino, Via Degli Imbimbo 10/12, 83100 Avellino, Italy;
| | - Mena Volpe
- Department of Radiology, San Giuseppe Moscati Hospital, Contrada Amoretta, 83100 Avellino, Italy; (M.V.); (G.L.); (A.R.); (G.G.); (P.F.M.C.); (E.G.); (F.M.); (F.P.); (V.P.); (M.B.); (L.C.); (L.A.M.)
| | - Giulio Lombardi
- Department of Radiology, San Giuseppe Moscati Hospital, Contrada Amoretta, 83100 Avellino, Italy; (M.V.); (G.L.); (A.R.); (G.G.); (P.F.M.C.); (E.G.); (F.M.); (F.P.); (V.P.); (M.B.); (L.C.); (L.A.M.)
| | - Alessandro Rosa
- Department of Radiology, San Giuseppe Moscati Hospital, Contrada Amoretta, 83100 Avellino, Italy; (M.V.); (G.L.); (A.R.); (G.G.); (P.F.M.C.); (E.G.); (F.M.); (F.P.); (V.P.); (M.B.); (L.C.); (L.A.M.)
| | - Giuliano Gagliardi
- Department of Radiology, San Giuseppe Moscati Hospital, Contrada Amoretta, 83100 Avellino, Italy; (M.V.); (G.L.); (A.R.); (G.G.); (P.F.M.C.); (E.G.); (F.M.); (F.P.); (V.P.); (M.B.); (L.C.); (L.A.M.)
| | - Pietro Fabio Maurizio Capasso
- Department of Radiology, San Giuseppe Moscati Hospital, Contrada Amoretta, 83100 Avellino, Italy; (M.V.); (G.L.); (A.R.); (G.G.); (P.F.M.C.); (E.G.); (F.M.); (F.P.); (V.P.); (M.B.); (L.C.); (L.A.M.)
| | - Enzo Gravino
- Department of Radiology, San Giuseppe Moscati Hospital, Contrada Amoretta, 83100 Avellino, Italy; (M.V.); (G.L.); (A.R.); (G.G.); (P.F.M.C.); (E.G.); (F.M.); (F.P.); (V.P.); (M.B.); (L.C.); (L.A.M.)
| | - Francesca Maio
- Department of Radiology, San Giuseppe Moscati Hospital, Contrada Amoretta, 83100 Avellino, Italy; (M.V.); (G.L.); (A.R.); (G.G.); (P.F.M.C.); (E.G.); (F.M.); (F.P.); (V.P.); (M.B.); (L.C.); (L.A.M.)
| | - Francesco Pane
- Department of Radiology, San Giuseppe Moscati Hospital, Contrada Amoretta, 83100 Avellino, Italy; (M.V.); (G.L.); (A.R.); (G.G.); (P.F.M.C.); (E.G.); (F.M.); (F.P.); (V.P.); (M.B.); (L.C.); (L.A.M.)
| | - Valentina Picariello
- Department of Radiology, San Giuseppe Moscati Hospital, Contrada Amoretta, 83100 Avellino, Italy; (M.V.); (G.L.); (A.R.); (G.G.); (P.F.M.C.); (E.G.); (F.M.); (F.P.); (V.P.); (M.B.); (L.C.); (L.A.M.)
| | - Marcella Buono
- Department of Radiology, San Giuseppe Moscati Hospital, Contrada Amoretta, 83100 Avellino, Italy; (M.V.); (G.L.); (A.R.); (G.G.); (P.F.M.C.); (E.G.); (F.M.); (F.P.); (V.P.); (M.B.); (L.C.); (L.A.M.)
| | - Lorenzo Colucci
- Department of Radiology, San Giuseppe Moscati Hospital, Contrada Amoretta, 83100 Avellino, Italy; (M.V.); (G.L.); (A.R.); (G.G.); (P.F.M.C.); (E.G.); (F.M.); (F.P.); (V.P.); (M.B.); (L.C.); (L.A.M.)
| | - Lanfranco Aquilino Musto
- Department of Radiology, San Giuseppe Moscati Hospital, Contrada Amoretta, 83100 Avellino, Italy; (M.V.); (G.L.); (A.R.); (G.G.); (P.F.M.C.); (E.G.); (F.M.); (F.P.); (V.P.); (M.B.); (L.C.); (L.A.M.)
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22
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Khosravi B, Sorouri M, Abdollahi M, Kasaeian A, Radmard AR. Outcome prediction based on initial CT scan in COVID-19. Heart Lung 2021; 50:361-362. [PMID: 33529847 PMCID: PMC7826104 DOI: 10.1016/j.hrtlng.2021.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 01/21/2021] [Indexed: 11/05/2022]
Affiliation(s)
- Bardia Khosravi
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Sorouri
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Abdollahi
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Kasaeian
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Reza Radmard
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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23
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Fonseca EKUN, Assunção AN, Araujo-Filho JDAB, Ferreira LC, Loureiro BMC, Strabelli DG, de Farias LDPG, Chate RC, Cerri GG, Sawamura MVY, Nomura CH. Lung Lesion Burden found on Chest CT as a Prognostic Marker in Hospitalized Patients with High Clinical Suspicion of COVID-19 Pneumonia: a Brazilian experience. Clinics (Sao Paulo) 2021; 76:e3503. [PMID: 34878032 PMCID: PMC8610222 DOI: 10.6061/clinics/2021/e3503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 10/27/2021] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE To investigate the relationship between lung lesion burden (LLB) found on chest computed tomography (CT) and 30-day mortality in hospitalized patients with high clinical suspicion of coronavirus disease 2019 (COVID-19), accounting for tomographic dynamic changes. METHODS Patients hospitalized with high clinical suspicion of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in a dedicated and reference hospital for COVID-19, having undergone at least one RT-PCR test, regardless of the result, and with one CT compatible with COVID-19, were retrospectively studied. Clinical and laboratory data upon admission were assessed, and LLB found on CT was semi-quantitatively evaluated through visual analysis. The primary outcome was 30-day mortality after admission. Secondary outcomes, including the intensive care unit (ICU) admission, mechanical ventilation used, and length of stay (LOS), were assessed. RESULTS A total of 457 patients with a mean age of 57±15 years were included. Among these, 58% presented with positive RT-PCR result for COVID-19. The median time from symptom onset to RT-PCR was 8 days [interquartile range 6-11 days]. An initial LLB of ≥50% using CT was found in 201 patients (44%), which was associated with an increased crude at 30-day mortality (31% vs. 15% in patients with LLB of <50%, p<0.001). An LLB of ≥50% was also associated with an increase in the ICU admission, the need for mechanical ventilation, and a prolonged LOS after adjusting for baseline covariates and accounting for the CT findings as a time-varying covariate; hence, patients with an LLB of ≥50% remained at a higher risk at 30-day mortality (adjusted hazard ratio 2.17, 95% confidence interval 1.47-3.18, p<0.001). CONCLUSION Even after accounting for dynamic CT changes in patients with both clinical and imaging findings consistent with COVID-19, an LLB of ≥50% might be associated with a higher risk of mortality.
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24
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Hajiahmadi S, Shayganfar A, Janghorbani M, Esfahani MM, Mahnam M, Bakhtiarvand N, Sami R, Khademi N, Dehghani M. Chest Computed Tomography Severity Score to Predict Adverse Outcomes of Patients with COVID-19. Infect Chemother 2021; 53:308-318. [PMID: 34216124 PMCID: PMC8258285 DOI: 10.3947/ic.2021.0024] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 04/20/2021] [Indexed: 01/19/2023] Open
Abstract
Background The novel coronavirus disease 2019 (COVID-19) continues to wreak havoc worldwide. This study assessed the ability of chest computed tomography (CT) severity score (CSS) to predict intensive care unit (ICU) admission and mortality in patients with COVID-19 pneumonia. Materials and Methods A total of 192 consecutive patients with COVID-19 pneumonia aged more than 20 years and typical CT findings and reverse-transcription polymerase chain reaction positive admitted in a tertiary hospital were included. Clinical symptoms at admission and short-term outcome were obtained. A semi-quantitative scoring system was used to evaluate the parenchymal involvement. The association between CSS, disease severity, and outcomes were evaluated. Prediction of CSS was assessed with the area under the receiver-operating characteristic (ROC) curves. Results The incidence of admission to ICU was 22.8% in men and 14.1% in women. CSS was related to ICU admission and mortality. Areas under the ROC curves were 0.764 for total CSS. Using a stepwise binary logistic regression model, gender, age, oxygen saturation, and CSS had a significant independent relationship with ICU admission and death. Patients with CSS ≥12.5 had about four-time risk of ICU admission and death (odds ratio 1.66, 95% confidence interval 1.66 – 9.25). The multivariate regression analysis showed the superiority of CSS over other clinical information and co-morbidities. Conclusion CSS was a strong predictor of progression to ICU admission and death and there was a substantial role of non-contrast chest CT imaging in the presence of typical features for COVID-19 pneumonia as a reliable predictor of clinical severity and patient’s outcome.
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Affiliation(s)
- Somayeh Hajiahmadi
- Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azin Shayganfar
- Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohsen Janghorbani
- Department of Epidemiology and Biostatistics, Isfahan University of Medical Sciences, Isfahan, Iran.
| | | | - Mehdi Mahnam
- Department of Industrial and Systems Engineering, Isfahan University of Technology, Isfahan, Iran.,Center for Optimization and Intelligent Decision making in Healthcare systems (COID-Health), Isfahan University of Technology, Isfahan, Iran
| | - Nagar Bakhtiarvand
- Department of Industrial and Systems Engineering, Isfahan University of Technology, Isfahan, Iran
| | - Ramin Sami
- Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nilufar Khademi
- Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehrnegar Dehghani
- Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran
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25
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Kalemci S, Sarıhan A, Zeybek A. Initial CT scan and its relationship with Covid-19. Heart Lung 2020; 50:177. [PMID: 33248419 PMCID: PMC7674132 DOI: 10.1016/j.hrtlng.2020.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 11/06/2020] [Accepted: 11/11/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Serdar Kalemci
- Department of Chest Diseases, Medical Park Gebze Hospital, Kocaeli, Turkey
| | - Aydın Sarıhan
- Department of Emergency Medicine, Manisa City Hospital, Manisa, Turkey.
| | - Arife Zeybek
- Department of Chest Surgery, Muğla Sıtkı Koçman University, School of Medicine, Muğla, Turkey
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