Nadem Boueini Nima, Haage Patrick, Abanador-Kamper Nadine, Kamper Lars
Private Universität Witten/Herdecke, Alfred-Herrhausen-Straße 50, 58455, Witten, Deutschland.
Diagnostische und interventionelle Radiologie, HELIOS Universitätsklinikum Wuppertal, Heusnerstr. 40, 42283, Wuppertal, Deutschland.
Med Klin Intensivmed Notfmed. 2024 Jun;119(5):384-390. doi: 10.1007/s00063-023-01062-3. Epub 2023 Sep 25.
Pulmonary manifestation of coronavirus disease 2019 (COVID-19) is described using standardized computed tomography (CT) morphologic criteria. In this study, we investigated possible associations between thoracic CT manifestations in COVID-19 pneumonia and typical comorbidities, as well as clinical course.
We analyzed clinical data and pulmonary imaging of 61 patients with positive PCR test. Pulmonary changes were categorized and reviewed for associations with pre-existing comorbidities and clinical course.
Compared to patients with atypical infiltrate patterns (2/19, 10.5%), 25 patients with typical infiltrate patterns (25/42, 59.5%) were significantly more likely to receive intensive care (p<0.001). In addition, patients with typical infiltrate patterns were more likely to receive non-invasive ventilation (12/42, 28.6%, p=0.040) and high-flow therapy (8/42, 19%, p=0.041) compared to patients with atypical infiltrate patterns. Mortality was also higher in patients with typical infiltrate patterns, with 15 patients (15/42, 35.7%) dying during follow-up compared to only 1 patient with atypical infiltrate pattern (1/19, 10.5%, p=0.012). No significant association between specific comorbidities and the resulting infiltrate pattern could be demonstrated.
Patients with a typical COVID-19 infiltrate pattern are more likely to receive intensive care and show higher mortality rates. Further analysis with larger patient collectives is needed to identify specific risk factors for typical COVID-19 pneumonia.
采用标准化计算机断层扫描（CT）形态学标准描述2019冠状病毒病（COVID-19）的肺部表现。在本研究中，我们调查了COVID-19肺炎患者胸部CT表现与典型合并症以及临床病程之间可能存在的关联。
我们分析了61例PCR检测呈阳性患者的临床数据和肺部影像。对肺部变化进行分类，并审查其与既往合并症和临床病程的关联。
与非典型浸润模式的患者（2/19，10.5%）相比，25例典型浸润模式的患者（25/42，59.5%）接受重症监护的可能性显著更高（p<0.001）。此外，与非典型浸润模式的患者相比，典型浸润模式的患者更有可能接受无创通气（12/42，28.6%，p=0.040）和高流量治疗（8/42，19%，p=0.041）。典型浸润模式的患者死亡率也更高，随访期间有15例患者（15/42，35.7%）死亡，而非典型浸润模式的患者只有1例（1/19，10.5%，p=0.012）。未发现特定合并症与所产生的浸润模式之间存在显著关联。
具有典型COVID-19浸润模式的患者更有可能接受重症监护，且死亡率更高。需要对更多患者群体进行进一步分析，以确定典型COVID-19肺炎的特定危险因素。
