Can Chest Computed Tomography Findings of Symptomatic COVID-19 Patients Upon Admission Indicate Disease Prognosis and Clinical Outcome?

Abstract

This study aimed to investigate whether initial chest Computed Tomography (CT) findings of COVID-19 patients could predict clinical outcomes, prognoses, and mortality rates associated with the infection. Published studies on chest CT in COVID-19 infection do not go beyond describing the characteristics of the current period. Comparative analysis of chest CT findings upon hospital admission among patients with different clinical outcomes is scarce. We sought to retrospectively evaluate and compare clinical outcomes, prognoses, and mortality rates based upon the initial chest CT findings of 198 consecutive symptomatic patients with COVID-19 confirmed by Polymerase Chain Reaction (PCR). Patients (N = 198) were divided into three groups according to their clinical outcomes as follows: group 1 (n = 62) included patients discharged from the service, group 2 (n= 60) included patients hospitalized in the intensive care unit, and group 3 (n = 76) included patients who died despite treatment. Predictors of poor prognosis and mortality with regard to chest CT findings included mediastinal lymphadenopathy, pleural effusion, and pericardial effusion, and clinical characteristics of age, dyspnea, and hypertension. The halo sign on chest CT was a good prognosis predictor in multivariate analysis. Some CT findings, such as discharge, intensive care unit hospitalization, and death as the worst consequence, significantly correlated with endpoints. These findings support the role of CT imaging for potentially predicting clinical outcomes of patients with COVID-19.