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COVID-19 幸存者和非幸存者的 CT 表现与 CT 评分系统的临床应用。

CT findings in survivors and non-survivors of COVID-19 and clinical usefulness of a CT scoring system.

机构信息

Departamento de Medicina Interna, Hospital General de Zona N.º 27, Instituto Mexicano del Seguro Social, Mexico City, Mexico.

Departamento de Radiología, Hospital General de Zona N.° 27, Instituto Mexicano del Seguro Social, Mexico City, Mexico.

出版信息

Radiologia (Engl Ed). 2022 Jan-Feb;64(1):11-16. doi: 10.1016/j.rxeng.2021.09.003.

DOI:10.1016/j.rxeng.2021.09.003
PMID:35180982
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8845416/
Abstract

BACKGROUND

Many patients with coronavirus disease 2019 (COVID-19) have been diagnosed with computed tomography (CT). A prognostic tool based on CT findings could be useful for predicting death from COVID-19.

OBJECTIVES

To compare the chest CT findings of patients who survived COVID-19 versus those of patients who died of COVID-19 and to determine the usefulness the clinical usefulness of a CT scoring system for COVID-19.

METHODS

We included 124 patients with confirmed SARS-CoV-2 infections who were hospitalized between April 1, 2020 and July 25, 2020.

RESULTS

Whereas ground-glass opacities were the most common characteristic finding in survivors (75%), crazy paving was the most characteristic finding in non-survivors (65%). Atypical findings were present in 46% of patients. The chest CT score was directly proportional to mortality; a score ≥18 was the best cutoff for predicting death, yielding 70% sensitivity (95%CI: 47%-87%).

CONCLUSIONS

Our results suggest that atypical lesions are more prevalent in this cohort. The chest CT score had high sensitivity for predicting hospital mortality.

摘要

背景

许多新冠肺炎(COVID-19)患者已被诊断为计算机断层扫描(CT)。基于 CT 结果的预测工具可能有助于预测 COVID-19 死亡。

目的

比较 COVID-19 存活患者与 COVID-19 死亡患者的胸部 CT 表现,并确定 COVID-19 CT 评分系统的临床实用性。

方法

我们纳入了 2020 年 4 月 1 日至 7 月 25 日期间住院的 124 例确诊的 SARS-CoV-2 感染患者。

结果

磨玻璃影是幸存者最常见的特征性表现(75%),而铺路石征是非幸存者最特征性的表现(65%)。46%的患者存在不典型表现。胸部 CT 评分与死亡率直接相关;评分≥18 是预测死亡的最佳截断值,敏感性为 70%(95%CI:47%-87%)。

结论

我们的结果表明,在本队列中不典型病变更为常见。胸部 CT 评分对预测住院死亡率具有很高的敏感性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ee5/8845416/82ee6867d336/gr3_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ee5/8845416/56d3492018b5/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ee5/8845416/2c7e50e8a8d0/gr2_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ee5/8845416/82ee6867d336/gr3_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ee5/8845416/56d3492018b5/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ee5/8845416/2c7e50e8a8d0/gr2_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ee5/8845416/82ee6867d336/gr3_lrg.jpg

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Pulmonary Angiopathy in Severe COVID-19: Physiologic, Imaging, and Hematologic Observations.严重 COVID-19 中的肺血管病:生理学、影像学和血液学观察。
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Eur Radiol. 2020 Dec;30(12):6808-6817. doi: 10.1007/s00330-020-07033-y. Epub 2020 Jul 4.
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Diagnostic Performance of CT and Reverse Transcriptase Polymerase Chain Reaction for Coronavirus Disease 2019: A Meta-Analysis.CT 与逆转录聚合酶链反应检测 2019 年冠状病毒病的诊断性能:一项荟萃分析。
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