新型冠状病毒肺炎患者CT表现变化与临床病程的相关性：一项单中心回顾性研究
Association Between CT Finding Changes and Clinical Course in COVID-19 Patients: A Single Center Retrospective Study.
作者信息
Mahdavi Ali Akbar, Raoufi Masoomeh, Hashemi Mina, Aghaiepour Rezvan, Mardanparvar Hossein, Asaadi Sina, Bakhshayesh Karam Mehrdad
机构信息
Department of Radiology, Imam Hossein Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Nursing, Faculty of Nursing & Midwifery, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
出版信息
Tanaffos. 2024 Feb;23(2):170-175.
BACKGROUND
This study aimed to summarize the baseline and radiological characteristics of patients with COVID-19 and investigate the correlation between clinical outcomes and radiological findings in the first week after admission.
MATERIALS AND METHODS
A single-center retrospective study was carried out on confirmed cases of COVID-19 based on RT-PCR and chest CT scan findings according to Iran's National Guidelines for defining COVID-19 in patients admitted to Imam Hossein Hospital, Tehran, Iran. Baseline and chest CT scan characteristics of patients were investigated, and their correlation with the change in clinical outcome was reported.
RESULTS
72 patients (50%) with a mean age of 54.65±16.2 years were in two periods of time including the first day of diagnosis and 6.0±3.4 days later. Based on CT scan Severity Score (CTSS) changes (decrease/no change or increase) during the study, patients were divided into two groups of CTSS progression (n=47) and CTSS no-progression (n=25). Diabetes mellitus (20%) and hypertension (19.1%) were the most frequent comorbidities among the patients in the non-progression and progression groups, respectively. There was no significant difference in demographic features including age and gender, and comorbidities (P>0.05). On the first day of diagnosis, there was no significant difference in blood tests and radiological findings and the number of patients who managed out-patients or in-patients in both groups. However, on the second evaluation day, patients in the progression group had significantly higher CTSS in comparison with the non-progression group (13.11±4.7 vs. 9.48±4.2, P=0.003), and the clinical situation in 15 patients in progression changed from out-patient to in-patient (p=0.033). Only chest CT imaging score was a potential parameter associated with the change in clinical progression (P=0.030, RR=10.18, 95, CI=1.25-89.72).
CONCLUSION
Increasing CTSS is a strong predictor of worsening clinical outcomes during hospitalization in COVID-19 patients.
背景
本研究旨在总结新型冠状病毒肺炎（COVID-19）患者的基线和影像学特征，并调查入院后第一周临床结局与影像学表现之间的相关性。
材料与方法
根据伊朗德黑兰伊玛目侯赛因医院收治患者中COVID-19的定义的国家指南，基于逆转录聚合酶链反应（RT-PCR）和胸部CT扫描结果，对确诊的COVID-19病例进行了单中心回顾性研究。调查了患者的基线和胸部CT扫描特征，并报告了它们与临床结局变化的相关性。
结果
72例患者（50%），平均年龄54.65±16.2岁，处于两个时间段，包括诊断第一天及6.0±3.4天后。根据研究期间CT扫描严重程度评分（CTSS）变化（降低/无变化或升高），将患者分为CTSS进展组（n=47）和CTSS无进展组（n=25）。非进展组和进展组患者中最常见的合并症分别为糖尿病（20%）和高血压（19.1%）。在年龄、性别等人口统计学特征及合并症方面无显著差异（P>0.05）。诊断第一天，两组患者的血液检查、影像学表现以及门诊或住院患者数量均无显著差异。然而，在第二次评估日，进展组患者的CTSS显著高于非进展组（13.·11±4.7 vs. 9.48±4.2，P=0.003），进展组中有15例患者的临床情况从门诊变为住院（P=0.033）。只有胸部CT影像评分是与临床进展变化相关的潜在参数（P=0.030，RR=10.18，95%CI=1.25-89.72）。
结论
CTSS升高是COVID-19患者住院期间临床结局恶化的有力预测指标。
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