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Pasculli P, Zingaropoli MA, Masci GM, Mazzuti L, Perri V, Paribeni F, Russo G, Arcari G, Iafrate F, Vullo F, Galardo G, La Torre G, Turriziani O, Antonelli G, Ricci P, Catalano C, Mastroianni CM, Ciardi MR. Chest computed tomography score, cycle threshold values and secondary infection in predicting COVID-19 mortality. New Microbiol 2021; 44:145-154. [PMID: 34783349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 11/16/2021] [Indexed: 06/13/2023]
Abstract
This retrospective and observational cohort study investigated chest computed tomography (CT) findings, cycle threshold (Ct) values in RT-PCR of SARS-CoV-2 and secondary infection occurrence to predict prognosis in COVID-19 patients. At hospital admission, CT findings and Ct values were collected. Microbiology tests performed after 48 hours from hospitalization were reviewed. According to in-hospital mortality, patients were grouped into non-survivors and survivors. Among 283 patients evaluated, in-hospital mortality rate was 13.8% (39/283). Secondary infection occurrence was 15.2% (43/283). Cut-off values for CT score >13.5 (AUC=0.682 p=0.0009) and for Ct <23.4 (AUC=0.749, p<0.0001) were predictive of death. Super-additive and synergic effects between high CT score plus secondary infection occurrence as well as between high CT score plus low Ct values affecting patient's outcome were observed. Chest CT score and Ct values in RT-PCR of SARS-CoV-2 could have a combination role for severity stratification of COVID-19 patients.
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Affiliation(s)
- Patrizia Pasculli
- Department of Public Health and Infectious Diseases, Sapienza, University of Rome, Italy
| | - Maria A. Zingaropoli
- Department of Public Health and Infectious Diseases, Sapienza, University of Rome, Italy
| | - Giorgio M. Masci
- Department of Radiological, Oncological and Pathological Sciences, Sapienza, University of Rome, Italy
| | - Laura Mazzuti
- Department of Molecular Medicine, Sapienza, University of Rome, Italy
| | - Valentina Perri
- Department of Public Health and Infectious Diseases, Sapienza, University of Rome, Italy
| | - Filippo Paribeni
- Department of Public Health and Infectious Diseases, Sapienza, University of Rome, Italy
| | - Gianluca Russo
- Department of Public Health and Infectious Diseases, Sapienza, University of Rome, Italy
| | - Gabriele Arcari
- Department of Molecular Medicine, Sapienza, University of Rome, Italy
| | - Franco Iafrate
- Department of Radiological, Oncological and Pathological Sciences, Sapienza, University of Rome, Italy
| | - Francesco Vullo
- Department of Radiological, Oncological and Pathological Sciences, Sapienza, University of Rome, Italy
| | - Gioacchino Galardo
- Medical Emergency Unit, Sapienza, University of Rome, Policlinico Umberto I, Rome, Italy
| | - Giuseppe La Torre
- Department of Public Health and Infectious Diseases, Sapienza, University of Rome, Italy
| | | | - Guido Antonelli
- Department of Molecular Medicine, Sapienza, University of Rome, Italy
| | - Paolo Ricci
- Department of Radiological, Oncological and Pathological Sciences, Sapienza, University of Rome, Italy
- Unit of Emergency Radiology, Sapienza, University of Rome, Italy
| | - Carlo Catalano
- Department of Radiological, Oncological and Pathological Sciences, Sapienza, University of Rome, Italy
| | - Claudio M. Mastroianni
- Department of Public Health and Infectious Diseases, Sapienza, University of Rome, Italy
| | - Maria R. Ciardi
- Department of Public Health and Infectious Diseases, Sapienza, University of Rome, Italy
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