Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
Theranostics. 2020 Apr 27;10(12):5641-5648. doi: 10.7150/thno.46465. eCollection 2020.
: Chest computed tomography (CT) has been used for the coronavirus disease 2019 (COVID-19) monitoring. However, the imaging risk factors for poor clinical outcomes remain unclear. In this study, we aimed to assess the imaging characteristics and risk factors associated with adverse composite endpoints in patients with COVID-19 pneumonia. : This retrospective cohort study enrolled patients with laboratory-confirmed COVID-19 from 24 designated hospitals in Jiangsu province, China, between 10 January and 18 February 2020. Clinical and initial CT findings at admission were extracted from medical records. Patients aged < 18 years or without available clinical or CT records were excluded. The composite endpoints were admission to ICU, acute respiratory failure occurrence, or shock during hospitalization. The volume, density, and location of lesions, including ground-glass opacity (GGO) and consolidation, were quantitatively analyzed in each patient. Multivariable logistic regression models were used to identify the risk factors among age and CT parameters associated with the composite endpoints. : In this study, 625 laboratory-confirmed COVID-19 patients were enrolled; among them, 179 patients without an initial CT at admission and 25 patients aged < 18 years old were excluded and 421 patients were included in analysis. The median age was 48.0 years and the male proportion was 53% (224/421). During the follow-up period, 64 (15%) patients had a composite endpoint. There was an association of older age (odds ratio [OR], 1.04; 95% confidence interval [CI]: 1.01-1.06; = 0.003), larger consolidation lesions in the upper lung (Right: OR, 1.13; 95%CI: 1.03-1.25, =0.01; Left: OR,1.15; 95%CI: 1.01-1.32; = 0.04) with increased odds of adverse endpoints. : There was an association of older age and larger consolidation in upper lungs on admission with higher odds of poor outcomes in patients with COVID-19.
: 胸部计算机断层扫描（CT）已用于监测 2019 年冠状病毒病（COVID-19）。然而，不良临床结局的影像学危险因素仍不清楚。在这项研究中，我们旨在评估 COVID-19 肺炎患者的不良复合终点相关的影像学特征和危险因素。 : 这项回顾性队列研究纳入了 2020 年 1 月 10 日至 2 月 18 日期间，来自中国江苏省 24 家指定医院的经实验室确诊的 COVID-19 患者。从病历中提取入院时的临床和初始 CT 发现。排除年龄<18 岁或无临床或 CT 记录的患者。复合终点是住院期间入住 ICU、急性呼吸衰竭发生或休克。对每位患者的病变体积、密度和位置（包括磨玻璃影（GGO）和实变）进行定量分析。使用多变量逻辑回归模型确定年龄和 CT 参数与复合终点相关的危险因素。 : 在这项研究中，共纳入了 625 例经实验室确诊的 COVID-19 患者；其中，179 例患者入院时无初始 CT，25 例患者年龄<18 岁，排除这 204 例后，共纳入 421 例患者进行分析。中位年龄为 48.0 岁，男性比例为 53%（224/421）。在随访期间，有 64 例（15%）患者出现复合终点。年龄较大（优势比[OR]，1.04；95%置信区间[CI]：1.01-1.06； = 0.003）、上肺实变较大（右侧：OR，1.13；95%CI：1.03-1.25； = 0.01；左侧：OR，1.15；95%CI：1.01-1.32； = 0.04）与不良结局的发生几率增加相关。 : 入院时年龄较大和上肺实变较大与 COVID-19 患者预后较差的几率增加相关。
