Obe-A-Ndzem Holenn Serge Emmanuel, Mazoba Tacite Kpanya, Mukanga Désiré Yaya, Zokere Tyna Bongosepe, Lungela Djo, Makulo Jean-Robert, Ahuka Steve, Mbongo Angèle Tanzia, Molua Antoine Aundu
Department of Radiology and Medical Imaging, Hôpital Médecins de nuit SARL, Kinshasa, Democratic Republic of the Congo.
Department of Radiology and Medical Imaging, Cliniques Universitaires de Kinshasa, Kinshasa, Democratic Republic of the Congo.
Pulm Med. 2024 Apr 25;2024:5520174. doi: 10.1155/2024/5520174. eCollection 2024.
We included all patients with respiratory symptoms (dyspnea, fever, and cough) and/or respiratory failure admitted to the SOS Médecins de nuit SARL hospital, DR Congo, during the 2nd and 3rd waves of the COVID-19 pandemic. The diagnosis of COVID-19 was established based on RT-PCR anti-SARS-CoV-2 tests (G1 (RT-PCR positive) vs. G2 (RT-PCR negative)), and all patients had a chest CT on the day of admission. We retrieved the digital files of patients, precisely the clinical, biological, and chest CT parameters of the day of admission as well as the vital outcome (survival or death). Chest CT were read by a very high-definition console using Advantage Windows software and exported to the hospital network using the RadiAnt DICOM viewer. To determine the threshold for the percentage of lung lesions associated with all-cause mortality, we used ROC curves. Factors associated with death, including chest CT parameters, were investigated using logistic regression analysis.
The study included 200 patients (average age 56.2 ± 15.2 years; 19% diabetics and 4.5% obese), and COVID-19 was confirmed among 56% of them (G1). Chest CT showed that ground glass (72.3 vs. 39.8%), crazy paving (69.6 vs. 17.0%), and consolidation (83.9 vs. 22.7%), with bilateral and peripheral locations (68.8 vs. 30.7%), were more frequent in G1 vs. G2 ( < 0.001). No case of pulmonary embolism and fibrosis had been documented. The lung lesions affecting 30% of the parenchyma were informative in predicting death (area under the ROC curve at 0.705, = 0.017). In multivariate analysis, a percentage of lesions affecting 50% of the lung parenchyma increased the risk of dying by 7.194 (1.656-31.250).
The chest CT demonstrated certain characteristic lesions more frequently in patients in whom the diagnosis of COVID-19 was confirmed. The extent of lesions affecting at least half of the lung parenchyma from the first day of admission to hospital increases the risk of death by a factor of 7.
我们纳入了在刚果民主共和国SOS夜间医生SARL医院收治的、在新冠疫情第二波和第三波期间出现呼吸道症状（呼吸困难、发热和咳嗽）和/或呼吸衰竭的所有患者。新冠病毒病的诊断基于逆转录聚合酶链反应（RT-PCR）检测抗SARS-CoV-2结果（G1组（RT-PCR阳性）与G2组（RT-PCR阴性）），所有患者在入院当天均进行了胸部CT检查。我们获取了患者的数字文件，确切地说是入院当天的临床、生物学和胸部CT参数以及重要结局（生存或死亡）。胸部CT由一台超高清控制台使用Advantage Windows软件进行阅片，并使用RadiAnt DICOM查看器导出到医院网络。为了确定与全因死亡率相关的肺部病变百分比阈值，我们使用了ROC曲线。使用逻辑回归分析研究与死亡相关的因素，包括胸部CT参数。
该研究纳入了200例患者（平均年龄56.2±15.2岁；19%为糖尿病患者，4.5%为肥胖患者），其中56%确诊为新冠病毒病（G1组）。胸部CT显示，磨玻璃影（72.3%对39.8%）、铺路石样改变（69.6%对17.0%）和实变（83.9%对22.7%），以及双侧和外周分布（68.8%对30.7%），在G1组比G2组更常见（<0.001）。未记录到肺栓塞和肺纤维化病例。累及30%实质的肺部病变对预测死亡具有参考价值（ROC曲线下面积为0.705，P=0.017）。在多变量分析中，累及50%肺实质的病变百分比使死亡风险增加7.194倍（1.656 - 31.250）。
胸部CT显示，在确诊为新冠病毒病的患者中某些特征性病变更为常见。入院第一天累及至少一半肺实质的病变范围使死亡风险增加7倍。
