Witten/Herdecke University, Witten, Germany.
Clinical Radiology, Helios University Hospital Wuppertal, Wuppertal, Germany.
Medicine (Baltimore). 2023 Jul 14;102(28):e34359. doi: 10.1097/MD.0000000000034359.
Chest-computer tomography (CT) is a crucial factor in the clinical course and evaluation of patients with COVID-pneumonia. In the initial phase of the COVID-19 pandemic little information was known on the prognostic value of the initially taken thoracic CTs. The purpose of this study was to determine predictive values for clinical outcome based on CT classification of the pulmonary pathologies in patients with COVID-pneumonia. This single center study included 51 non-immunized patients during the first COVID-19 outbreak in Germany. The patients underwent a clinically indicated chest-CT. Using the radiological society of North America (RSNA)-report template, chest-CTs were classified into 4 categories (typical, atypical, indeterminate, and no changes). We analyzed the outcomes based on these imaging classifications and relevant comorbidities. Among the 51 patients of our study population 14 (27.5%) patients had a lethal outcome. Typical radiological COVID-19 pattern was found in 92.9% of the deceased patients and in 59.5% of the surviving patients (P = .022). The lethal group showed a significant higher proportion of diabetes mellitus (50% vs 10.8%; P = .003) and arterial hypertension (aHTN) (85.7% vs 54.1%; P = .037). Male sex, higher age and coronary heart disease (CHD) were also seen more often in the lethal group. In patients with clinically proven COVID-19 pneumonia, typical chest CT findings show a negative outcome. A classification system used in this study is helpful for classifying imaging features and is recommended as a standardized CT reporting tool. It could also help in triaging of the therapy of patients with COVID-19 pneumonia. Especially the comorbidities, diabetes and arterial hypertonia triggered a negative outcome in our study population.
胸部计算机断层扫描（CT）是 COVID-19 肺炎患者临床病程和评估的关键因素。在 COVID-19 大流行的初始阶段，人们对最初进行的胸部 CT 的预后价值知之甚少。本研究的目的是确定基于 COVID-19 肺炎患者肺部病变 CT 分类的临床结果预测值。这项单中心研究纳入了德国首次 COVID-19 爆发期间的 51 名未免疫患者。患者接受了临床指征明确的胸部 CT 检查。使用北美放射学会（RSNA）报告模板，将胸部 CT 分为 4 类（典型、非典型、不确定和无变化）。我们根据这些影像学分类和相关合并症分析了结果。在我们的研究人群中，51 例患者中有 14 例（27.5%）患者死亡。在死亡患者中，92.9%的患者存在典型的 COVID-19 影像学表现，而在存活患者中，这一比例为 59.5%（P=.022）。死亡组中糖尿病（50% vs. 10.8%；P=.003）和动脉高血压（aHTN）（85.7% vs. 54.1%；P=.037）的比例显著更高。在死亡组中，男性、高龄和冠心病（CHD）也更为常见。在经临床证实的 COVID-19 肺炎患者中，典型的胸部 CT 表现提示不良预后。本研究中使用的分类系统有助于对影像学特征进行分类，并被推荐作为一种标准化的 CT 报告工具。它还有助于 COVID-19 肺炎患者的治疗分诊。特别是在我们的研究人群中，合并症如糖尿病和动脉高血压会引发不良后果。
