Department of Obstetrics and Gynaecology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium.
Department of Radiology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium.
J Matern Fetal Neonatal Med. 2023 Dec;36(2):2241107. doi: 10.1080/14767058.2023.2241107.
To investigate the role of chest computed tomography (CT) scan in the prediction of admission of pregnant women with COVID-19 into intensive care unit (ICU).
This was a single-center retrospective case-control study. We included pregnant women diagnosed with COVID-19 by reverse transcriptase polymerase chain reaction between February 2020 and July 2021, requiring hospital admission due to symptoms, who also had a CT chest scan at presentation. Patients admitted to the ICU (case group) were compared with patients who did not require ICU admission (control group). The CT scans were reported by an experienced radiologist, blinded to the patient's course and outcome, aided by an artificial intelligence software. Total CT scan score, chest CT severity score (CT-SS), total lung volume (TLV), infected lung volume (ILV), and infected-to-total lung volume ratio (ILV/TLV) were calculated. Receiver operating characteristic curves were constructed to test the sensitivity and specificity of each parameter.
8/28 patients (28.6%) required ICU admission. These also had lower TLV, higher ILV, and ILV/TLV. The area under the curve (AUC) for these three parameters was 0.789, 0.775, and 0.763, respectively. TLV, ILV, and ILV/TLV had good sensitivity (62.5%, 87.5%, and 87.5%, respectively) and specificity (84.2%, 70%, and 73.7%, respectively) for predicting ICU admission at the following selected thresholds: 2255 mL, 319 mL, and 14%, respectively. The performance of CT-SS, CT scan score, and ILV/TLV in predicting ICU admission was comparable.
TLV, ILV, and ILV/TLV as measured by an artificial intelligence software on chest CT, may predict ICU admission in hospitalized pregnant women, symptomatic for COVID-19.
探讨胸部计算机断层扫描（CT）在预测 COVID-19 孕妇入住重症监护病房（ICU）中的作用。
这是一项单中心回顾性病例对照研究。我们纳入了 2020 年 2 月至 2021 年 7 月期间通过逆转录聚合酶链反应诊断为 COVID-19 的孕妇，这些孕妇因症状需要住院治疗，且在就诊时均进行了胸部 CT 扫描。将入住 ICU 的患者（病例组）与无需入住 ICU 的患者（对照组）进行比较。CT 扫描由一位有经验的放射科医生报告，报告时对患者的病程和结局不知情，由人工智能软件辅助。计算总 CT 扫描评分、胸部 CT 严重程度评分（CT-SS）、全肺容积（TLV）、感染肺容积（ILV）和感染肺容积比（ILV/TLV）。构建受试者工作特征曲线以测试每个参数的灵敏度和特异性。
28 例患者中有 8 例（28.6%）需要入住 ICU。这些患者的 TLV 较低，ILV 较高，ILV/TLV 比值也较高。这三个参数的曲线下面积（AUC）分别为 0.789、0.775 和 0.763。TLV、ILV 和 ILV/TLV 在预测 ICU 入住时具有良好的灵敏度（分别为 62.5%、87.5%和 87.5%）和特异性（分别为 84.2%、70%和 73.7%），在以下选定阈值下分别为：2255 毫升、319 毫升和 14%。CT-SS、CT 扫描评分和 ILV/TLV 预测 ICU 入住的性能相当。
胸部 CT 人工智能软件测量的 TLV、ILV 和 ILV/TLV 可能预测 COVID-19 孕妇住院期间是否需要入住 ICU。
