do Amaral E Castro Adham, Yokoo Patrícia, Fonseca Eduardo Kaiser Ururahy Nunes, Otoni Jessyca Couto, Haiek Sarah Lustosa, Shoji Hamilton, Chate Rodrigo Caruso, Pereira Andrea Z, Queiroz Marcos Roberto Gomes de, Batista Marcelo Costa, Szarf Gilberto
Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Hospital Israelita Albert Einstein, Goiânia, GO, Brazil.
Einstein (Sao Paulo). 2022 May 30;20:eAO6953. doi: 10.31744/einstein_journal/2022AO6953. eCollection 2022.
To evaluate anthropometric and clinical data, muscle mass, subcutaneous fat, spine bone mineral density, extent of acute pulmonary disease related to COVID-19, quantification of pulmonary emphysema, coronary calcium, and hepatic steatosis using chest computed tomography of hospitalized patients with confirmed diagnosis of COVID-19 pneumonia and verify its association with disease severity.
A total of 123 adults hospitalized due to COVID-19 pneumonia were enrolled in the present study, which evaluated the anthropometric, clinical and chest computed tomography data (pectoral and paravertebral muscle area and density, subcutaneous fat, thoracic vertebral bodies density, degree of pulmonary involvement by disease, coronary calcium quantification, liver attenuation measurement) and their association with poorer prognosis characterized through a combined outcome of intubation and mechanical ventilation, need of intensive care unit, and death.
Age (p=0.013), body mass index (p=0.009), lymphopenia (p=0.034), and degree of pulmonary involvement of COVID-19 pneumonia (p<0.001) were associated with poor prognosis. Extent of pulmonary involvement by COVID-19 pneumonia had an odds ratio of 1,329 for a poor prognosis and a cutoff value of 6.5 for increased risk, with a sensitivity of 64.9% and specificity of 67.1%.
The present study found an association of high body mass index, older age, extent of pulmonary involvement by COVID-19, and lymphopenia with severity of COVID-19 pneumonia in hospitalized patients.
利用确诊为新型冠状病毒肺炎的住院患者的胸部计算机断层扫描，评估人体测量学和临床数据、肌肉质量、皮下脂肪、脊柱骨密度、与新型冠状病毒肺炎相关的急性肺部疾病程度、肺气肿量化、冠状动脉钙化和肝脂肪变性，并验证其与疾病严重程度的关联。
本研究共纳入123例因新型冠状病毒肺炎住院的成年人，评估了人体测量学、临床和胸部计算机断层扫描数据（胸肌和椎旁肌面积及密度、皮下脂肪、胸椎椎体密度、疾病所致肺部受累程度、冠状动脉钙化量化、肝脏衰减测量）及其与通过插管和机械通气、重症监护病房需求和死亡的综合结果所表征的较差预后的关联。
年龄（p=0.013）、体重指数（p=0.009）、淋巴细胞减少（p=0.034）和新型冠状病毒肺炎的肺部受累程度（p<0.001）与预后不良相关。新型冠状病毒肺炎的肺部受累程度对于预后不良的比值比为1329，风险增加的临界值为6.5，敏感性为64.9%，特异性为67.1%。
本研究发现，高体重指数、老年、新型冠状病毒肺炎的肺部受累程度和淋巴细胞减少与住院患者新型冠状病毒肺炎的严重程度相关。
