Department of Radiology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, 26 Shengli Avenue, Jiangan, Wuhan, 430014, Hubei, China.
BMC Infect Dis. 2020 Dec 11;20(1):953. doi: 10.1186/s12879-020-05683-3.
The Coronavirus Disease 2019 (COVID-19) pandemic is a world-wide health crisis. Limited information is available regarding which patients will experience more severe disease symptoms. We evaluated hospitalized patients who were initially diagnosed with moderate COVID-19 for clinical parameters and radiological feature that showed an association with progression to severe/critical symptoms.
This study, a retrospective single-center study at the Central Hospital of Wuhan, enrolled 243 patients with confirmed COVID-19 pneumonia. Forty of these patients progressed from moderate to severe/critical symptoms during follow up. Demographic, clinical, laboratory, and radiological data were extracted from electronic medical records and compared between moderate- and severe/critical-type symptoms. Univariable and multivariable logistic regressions were used to identify the risk factors associated with symptom progression.
Patients with severe/critical symptoms were older (p < 0.001) and more often male (p = 0.046). A combination of chronic obstructive pulmonary disease (COPD) and high maximum chest computed tomography (CT) score was associated with disease progression. Maximum CT score (> 11) had the greatest predictive value for disease progression. The area under the receiver operating characteristic curve was 0.861 (95% confidence interval: 0.811-0.902).
Maximum CT score and COPD were associated with patient deterioration. Maximum CT score (> 11) was associated with severe illness.
2019 年冠状病毒病（COVID-19）大流行是一场全球性的卫生危机。关于哪些患者会出现更严重的疾病症状，信息有限。我们评估了最初被诊断为中度 COVID-19 的住院患者，以寻找与向严重/危重症症状进展相关的临床参数和影像学特征。
这项研究是在武汉市中心医院进行的回顾性单中心研究，共纳入了 243 例确诊为 COVID-19 肺炎的患者。其中 40 例在随访期间从中度进展为严重/危重症。从电子病历中提取人口统计学、临床、实验室和影像学数据，并在中度和严重/危重症症状之间进行比较。使用单变量和多变量逻辑回归来确定与症状进展相关的危险因素。
患有严重/危重症症状的患者年龄更大（p<0.001），且更多为男性（p=0.046）。COPD 合并高最大胸部 CT 评分与疾病进展相关。最大 CT 评分（>11）对疾病进展具有最大的预测价值。受试者工作特征曲线下面积为 0.861（95%置信区间：0.811-0.902）。
最大 CT 评分和 COPD 与患者恶化相关。最大 CT 评分（>11）与严重疾病相关。
