Department of Radiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.
Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, Jiangsu, China.
Eur Radiol. 2021 Oct;31(10):7342-7352. doi: 10.1007/s00330-021-07860-7. Epub 2021 Apr 15.
To investigate the association between longitudinal total pulmonary infection volume and volume ratio over time and clinical types in COVID-19 pneumonia patients.
This retrospective review included 367 patients with COVID-19 pneumonia. All patients underwent CT examination at baseline and/or one or more follow-up CT. Patients were categorized into two clinical types (moderate and severe groups). The severe patients were matched to the moderate patients via propensity scores (PS). The association between total pulmonary infection volume and volume ratio and clinical types was analyzed using a generalized additive mixed model (GAMM).
Two hundred and seven moderate patients and 160 severe patients were enrolled. The baseline clinical and imaging variables were balanced using PS analysis to avoid patient selection bias. After PS analysis, 172 pairs of moderate patients were allocated to the groups; there was no difference in the clinical and CT characteristics between the two groups (p > 0.05). A total of 332 patients, including 396 CT scans, were assessed. The impact of total pulmonary infection volume and volume ratio with time was significantly affected by clinical types (p for interaction = 0.01 and 0.01, respectively) using GAMM. Total pulmonary infection volume and volume ratio of the severe group increased by 14.66 cm (95% confidence interval [CI]: 3.92 to 25.40) and 0.45% (95% CI: 0.13 to 0.77) every day, respectively, compared to that of the moderate group.
Longitudinal total pulmonary infection volume and volume ratio are independently associated with the clinical types of COVID-19 pneumonia.
• The impact of total pulmonary infection volume and volume ratio over time was significantly affected by the clinical types (p for interaction = 0.01 and 0.01, respectively) using the GAMM. • Total pulmonary infection volume and volume ratio of the severe group increased by 14.66 cm (95% CI: 3.92 to 25.40) and 0.45% (95% CI: 0.13 to 0.77) every day, respectively, compared to that of the moderate group.
探讨新冠肺炎患者肺部总感染体积及其随时间变化的体积比与临床类型之间的关系。
本回顾性研究纳入了 367 例新冠肺炎患者。所有患者均在基线及（或）一次或多次随访时进行 CT 检查。患者分为两种临床类型（中症组和重症组）。通过倾向评分（PS）将重症患者与中症患者进行匹配。采用广义加性混合模型（GAMM）分析肺部总感染体积及其随时间变化的体积比与临床类型之间的关系。
共纳入 207 例中症患者和 160 例重症患者。通过 PS 分析平衡了基线临床和影像学变量，以避免患者选择偏倚。PS 分析后，172 对中症患者被分配到两组；两组间的临床和 CT 特征无差异（p>0.05）。共评估了 332 例患者（共 396 次 CT 扫描）。GAMM 分析显示，肺部总感染体积及其随时间变化的体积比与临床类型的交互作用具有统计学意义（p 交互=0.01 和 0.01）。与中症组相比，重症组肺部总感染体积及其体积比每天分别增加 14.66cm（95%置信区间[CI]：3.92 至 25.40）和 0.45%（95% CI：0.13 至 0.77）。
肺部总感染体积及其随时间变化的体积比与新冠肺炎患者的临床类型独立相关。
• 使用 GAMM，肺部总感染体积及其随时间变化的体积比与临床类型的交互作用具有统计学意义（p 交互=0.01 和 0.01）。
• 与中症组相比，重症组肺部总感染体积及其体积比每天分别增加 14.66cm（95% CI：3.92 至 25.40）和 0.45%（95% CI：0.13 至 0.77）。
