Raoufi Masoomeh, Safavi Naini Seyed Amir Ahmad, Azizan Zahra, Jafar Zade Fatemeh, Shojaeian Fatemeh, Ghanbari Boroujeni Masoud, Robatjazi Farzaneh, Haghighi Mehrdad, Arhami Dolatabadi Ali, Soleimantabar Hossein, Shoaee Simindokht, Hatamabadi Hamidreza
Department of Radiology, School of Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Imam Hossein Clinical Research Development Center, Imam Hossein Hospital, Shahid Beheshti university of Medical Science, Tehran, Iran.
Arch Acad Emerg Med. 2020 May 14;8(1):e57. eCollection 2020.
Predicting the outcomes of COVID-19 cases using different clinical, laboratory, and imaging parameters is one of the most interesting fields of research in this regard. This study aimed to evaluate the correlation between chest computed tomography (CT) scan findings and outcomes of COVID-19 cases.
This cross sectional study was carried out on confirmed COVID-19 cases with clinical manifestations and chest CT scan findings based on Iran's National Guidelines for defining COVID-19. Baseline and chest CT scan characteristics of patients were investigated and their correlation with mortality was analyzed and reported using SPSS 21.0.
380 patients with the mean age of 53.62 ± 16.66 years were evaluated (66.1% male). The most frequent chest CT scan abnormalities were in peripheral (86.6%) and peribronchovascular interstitium (34.6%), with ground glass pattern (54.1%), and round (53.6%) or linear (46.7%) shape. There was a significant correlation between shape of abnormalities (p = 0.003), CT scan Severity Score (CTSS) (p <0.0001), and pulmonary artery CT diameter (p = 0. 01) with mortality. The mean CTSS of non-survived cases was significantly higher (13.68 ± 4.59 versus 8.72 ± 4.42; <0.0001). The area under the receiver operating characteristic (ROC) curve of CTSS in predicting the patients' mortality was 0.800 (95% CI: 0.716-0.884). The best cut off point of chest CTSS in this regard was 12 with 75.82% (95% CI: 56.07%-88.98%) sensitivity and 75.78% (95% CI: 70.88%-80.10%) specificity. The mean main pulmonary artery diameter in patients with CTSS ≥ 12 was higher than cases with CTSS < 12 (27.89 ± 3.73 vs 26.24 ± 3.14 mm; p < 0.0001).
Based on the results of the present study it seems that there is a significant correlation between chest CT scan characteristics and mortality of COVID-19 cases. Patients with lower CTSS, lower pulmonary artery CT diameter, and round shape opacity had lower mortality.
利用不同的临床、实验室和影像学参数预测新冠病毒病（COVID-19）病例的预后是这方面最有趣的研究领域之一。本研究旨在评估胸部计算机断层扫描（CT）扫描结果与COVID-19病例预后之间的相关性。
本横断面研究针对根据伊朗COVID-19定义国家指南确诊的有临床表现和胸部CT扫描结果的COVID-19病例进行。调查患者的基线和胸部CT扫描特征，并使用SPSS 21.0分析其与死亡率的相关性并进行报告。
评估了380例患者，平均年龄为53.62±16.66岁（男性占66.1%）。最常见的胸部CT扫描异常位于外周（86.6%）和支气管血管周围间质（34.6%），表现为磨玻璃影（54.1%），呈圆形（53.6%）或线性（46.7%）。异常形态（p = 0.003）、CT扫描严重程度评分（CTSS）（p <0.0001）和肺动脉CT直径（p = 0.01）与死亡率之间存在显著相关性。未存活病例的平均CTSS显著更高（13.68±4.59对8.72±4.42；<0.0001）。CTSS预测患者死亡率的受试者工作特征（ROC）曲线下面积为0.800（95%CI：0.716 - 0.884）。在这方面，胸部CTSS的最佳截断点为12，灵敏度为75.82%（95%CI：56.07% - 88.98%），特异度为75.78%（95%CI：70.88% - 80.10%）。CTSS≥12的患者的平均主肺动脉直径高于CTSS<12的患者（27.89±3.73对26.24±3.1 mm；p <0.0001）。
根据本研究结果，胸部CT扫描特征与COVID-19病例的死亡率之间似乎存在显著相关性。CTSS较低、肺动脉CT直径较小且为圆形不透明影的患者死亡率较低。
