Abstract
The aim of this study was to assess the prognostic value of baseline clinical and high resolution CT (HRCT) findings in patients with severe COVID-19. In this retrospective, two-center study, we included two groups of inpatients with severe COVID-19 who had been discharged or died in Jin Yin-tan hospital and Wuhan union hospital between January 5, 2020, and February 22, 2020. Cases were confirmed by real-time polymerase chain reaction. Demographic, clinical, and laboratory data, and HRCT imaging were collected and compared between discharged and deceased patients. Univariable and multivariable logistic regression models were used to assess predictors of mortality risk in these patients. 101 patients were included in this study, of whom 66 were discharged and 35 died in the hospital. The mean age was 56.6 ± 15.1 years and 67 (66.3%) were men. Of the 101 patients, hypertension (38, 37.6%), cardiovascular disease (21,20.8%), diabetes (18,17.8%), and chronic pulmonary disease (16,15.8%) were the most common coexisting conditions. The multivariable regression analysis showed older age (OR: 1.142, 95% CI 1.059–1.231, p < 0.001), acute respiratory distress syndrome (ARDS) (OR: 10.142, 95% CI 1.611–63.853, p = 0.014), reduced lymphocyte count (OR: 0.004, 95% CI 0.001–0.306, p = 0.013), and elevated HRCT score (OR: 1.276, 95% CI 1.002–1.625, p = 0.049) to be independent predictors of mortality risk on admission in severe COVID-19 patients. These findings may have important clinical implications for decision-making based on risk stratification of severe COVID-19 patients.
Highlights
In December 2019, a cluster of cases of pneumonia of unknown etiology, known as coronavirus disease 2019 (COVID-19), and the coronavirus was called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), were reported in Wuhan, Hubei province, C hina[1,2,3]
We have investigated the prognostic value of baseline clinical and high resolution CT (HRCT) findings in severe patients with COVID-19
In two previously published prognostic s tudies[11,12], included groups were not all severe patients and HRCT findings associated with poor clinical outcomes have not been specified
Summary
In December 2019, a cluster of cases of pneumonia of unknown etiology, known as coronavirus disease 2019 (COVID-19), and the coronavirus was called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), were reported in Wuhan, Hubei province, C hina[1,2,3]. Previous studies have demonstrated the epidemiological, clinical characteristics and clinical outcome in patients with COVID-19, which range from mild to critically ill c ases[2,3,8,9,10]. Some studies r evealed[11,12] risk factors associated with death of adult inpatients with COVID-19, including older age, high SOFA score, coagulation dysfunction, etc. The prognostic value of radiological findings in severe patients with COVID-19 was not reported, and previous studies[10,12] mainly focused on chest radiography rather than the more practical HRCT imaging. We aimed to evaluate the prognostic value of baseline clinical and HRCT findings in severe patients with COVID-19
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