Bucher Andreas Michael, Dietz Julia, Ehrengut Constantin, Müller Lukas, Schramm Dominik, Akinina Alena, Drechsel Michelle, Kloeckner Roman, Sieren Malte, Isfort Peter, Sähn Marwin-Jonathan, Fink Matthias A, Móré Dorottya, Melekh Bohdan, Meinel Felix G, Schön Hanna, May Matthias Stefan, Siegler Lisa, Münzfeld Hanna, Ruppel Richard, Penzkofer Tobias, Kim Moon-Sung, Balzer Miriam, Borggrefe Jan, Meyer Hans Jonas, Surov Alexey
Department of Diagnostic and Interventional Radiology, Goethe University Hospital Frankfurt, 60590, Frankfurt Am Main, Germany.
Department of Radiology, University Hospital of Leipzig, Leipzig, Germany..
Clin Imaging. 2025 Jan;117:110303. doi: 10.1016/j.clinimag.2024.110303. Epub 2024 Sep 26.
This study evaluates the prognostic significance of pleural effusion (PE) in COVID-19 patients across thirteen centers in Germany, aiming to clarify its role in predicting clinical outcomes.
In this retrospective analysis within the RACOON project (Radiological Cooperative Network of the COVID-19 pandemic), 1183 patients (29.3 % women, 70.7 % men) underwent chest CT to assess PE. We investigated PE's association with 30-day mortality, ICU admission, and the need for mechanical ventilation.
PE was detected in 31.5 % of patients, showing a significant correlation with 30-day mortality (47.5 % in non-survivors vs. 27.3 % in survivors, p < 0.001), with a hazard ratio of 2.22 (95 % CI 1.65-2.99, p < 0.001). No significant association was found between PE volume or density and mortality. ICU admissions were noted in 46.8 % of patients, while mechanical ventilation was required for 26.7 %.
Pleural effusion is present in a significant portion of COVID-19 patients and independently predicts increased 30-day mortality, underscoring its value as a prognostic marker. Its identification, irrespective of volume or density, should be a priority in radiological reports to guide clinical decision-making.
本研究评估了德国13个中心的COVID-19患者中胸腔积液（PE）的预后意义，旨在阐明其在预测临床结局中的作用。
在RACOON项目（COVID-19大流行的放射学合作网络）的这项回顾性分析中，1183例患者（29.3%为女性，70.7%为男性）接受了胸部CT检查以评估PE。我们调查了PE与30天死亡率、入住重症监护病房（ICU）以及机械通气需求之间的关联。
31.5%的患者检测到PE，其与30天死亡率显著相关（非幸存者中为47.5%，幸存者中为27.3%，p<0.001），风险比为2.22（95%CI 1.65-2.99，p<0.001）。未发现PE量或密度与死亡率之间存在显著关联。46.8%的患者入住了ICU，26.7%的患者需要机械通气。
COVID-19患者中有相当一部分存在胸腔积液，且其独立预测30天死亡率增加，突出了其作为预后标志物的价值。无论量或密度如何，在放射学报告中识别胸腔积液都应作为优先事项，以指导临床决策。
