Department of Radiology, Faculty of Medicine, Amasya University, Sabuncuoğlu Şerefeddin Research and Education Hospital, Amasya, Turkey.
Department of Radiology, Faculty of Medicine, Amasya University, Sabuncuoğlu Şerefeddin Research and Education Hospital, Amasya, Turkey.
Heart Lung. 2022 Jul-Aug;54:19-26. doi: 10.1016/j.hrtlng.2022.03.006. Epub 2022 Mar 10.
The presence of mediastinal lymph node enlargement (MLNE) in computed tomography (CT) of Coronavirus disease 2019 (COVID-19) patients can be associated with disease severity.
To investigate the relationship between MLNE with intensive care unit admission (ICU), mortality rates, and CT findings, especially in early-stage COVID-19 patients.
This single-center retrospective case-control study, included aged ≥18 years, 250 COVID-19 patients with positive RT-PCR tests. We included two patient groups, 125/250 with and without MLNE. Demographic information of the patients, laboratory findings, length of stay in hospital or ICU, mortality rates, initial CT imaging findings and CT severity scores (CT-SS) were recorded and their relationship with MLNE was investigated.
Patients with MLNE were older (69.61 ± 11.16; p < 0.001) and had a higher CT-SS (14.67 ± 7.55; p < 0.001). There was a significant difference between the presence of MLNE with mortality (58/77, 75.3%; p < 0.001) and ICU admission (49/61, 80.3%; p < 0.001). Also, a statistical association was found between MLNE with ICU admission (p = 0.001) and (p < 0.001) mortality rates in patients with CORADS≤2 CT findings. In multivariate logistic regression analysis, MLNE was 8.8-fold (95% CI: 1.62-47.86, p = 0.01) more correlated with linear opacity and 0.25-fold with bronchial wall thickening (95% CI: 0.07-0.92, p = 0.04).
Mediastinal lymph node enlargement is an important CT finding that can predict the severe prognosis of COVID-19 patients. Even in patients without lung involvement on initial CT, the presence of MLNE should be carefully examined as it is associated with disease severity.
在计算机断层扫描（CT）中发现 2019 冠状病毒疾病（COVID-19）患者纵隔淋巴结肿大（MLNE）可能与疾病严重程度相关。
研究 MLNE 与重症监护病房（ICU）入住率、死亡率和 CT 表现之间的关系，尤其是在 COVID-19 早期患者中。
本单中心回顾性病例对照研究，纳入年龄≥18 岁、250 例 RT-PCR 检测阳性的 COVID-19 患者。我们纳入了两组患者，250 例患者中有 125 例和无 MLNE。记录患者的人口统计学资料、实验室检查结果、住院或 ICU 住院时间、死亡率、初始 CT 影像学表现和 CT 严重程度评分（CT-SS），并探讨其与 MLNE 的关系。
MLNE 患者年龄较大（69.61±11.16；p<0.001）且 CT-SS 较高（14.67±7.55；p<0.001）。MLNE 与死亡率（58/77，75.3%；p<0.001）和 ICU 入住率（49/61，80.3%；p<0.001）之间存在显著差异。此外，在 CORADS≤2 CT 表现的患者中，MLNE 与 ICU 入住率（p=0.001）和死亡率（p<0.001）之间存在统计学关联。在多变量逻辑回归分析中，MLNE 与线性混浊的相关性更强（8.8 倍，95%CI：1.62-47.86，p=0.01），与支气管壁增厚的相关性更弱（0.25 倍，95%CI：0.07-0.92，p=0.04）。
纵隔淋巴结肿大是 COVID-19 患者的重要 CT 表现，可预测其严重预后。即使在初始 CT 无肺部受累的患者中，也应仔细检查 MLNE 的存在，因为它与疾病严重程度相关。
