Tomographic characteristics of lung lesions in hospitalized patients with COVID-19 and its prognostic value.

Características tomográficas de las lesiones pulmonares en pacientes hospitalizados con COVID-19 y su valor pronóstico.

• María Montes de Oca Hospital Centro Médico de Caracas
• Eleonora García Hospital Centro Médico de Caracas
• Laura Sánchez-Traslaviña Hospital Centro Médico de Caracas
• Fátima Gutiérrez-Correia Hospital Centro Médico de Caracas
• Irene Stulin Hospital Centro Médico de Caracas
• Gabriela Blanco Hospital Centro Médico de Caracas
• Isabel-Carlota Silva Hospital Centro Médico de Caracas
• Jennireth Quevedo Hospital Centro Médico de Caracas
• María Cristina Arvelo Hospital Centro Médico de Caracas
• Nathalia Valera Hospital Centro Médico de Caracas
• Irene Papa Hospital Centro Médico de Caracas
• Santiago Bacci Hospital Centro Médico de Caracas
• Fátima De Abreu Hospital Centro Médico de Caracas
• Héctor Villarroel Hospital Centro Médico de Caracas
• Juan Carlos Catari Hospital Centro Médico de Caracas
• José Luis Lopez Hospital Centro Médico de Caracas
• Brigitte Moran Hospital Centro Médico de Caracas
• Claudio Cárdenas Hospital Centro Médico de Caracas
• Saverio Santucci Hospital Centro Médico de Caracas
• José Luis Viloria Hospital Centro Médico de Caracas
• Jerry Gómez Hospital Centro Médico de Caracas
• Antonio Martinelli Hospital Centro Médico de Caracas
• Manuel Guzmán Hospital Centro Médico de Caracas

DOI: https://doi.org/10.22209/IC.v62n4a06

Keywords: COVID-19, SARS-CoV-2, chest tomography, mortality

Abstract

The severity of lung involvement on chest tomography (CT) images in COVID-19 patients may have a prognostic value. This study assesses the type, severity and frequency of the different images of lung CT in hospitalized patients with COVID-19, and the differences in clinical characteristics and in-hospital outcomes, according to the CT severity score. This represents an observational study (retrospective cohort) of hospitalized patients with COVID-19. The ISARIC-WHO form was used to collect data. The type of lung lesions, affected lobes, and total CT severity score were determined at hospital admission. The first, second and third quartiles of the total CT score were calculated to divide the sample into four equal parts (Q1, Q2, Q3 and Q4). A total of 556 patients were included, 336 men (60.4%) and 220 women (39.6%), with a mean age of 61.9±15.8 years; and 532 of them had CT scan at admission. Patients in the more severe quartiles had more days of symptoms evolution (Q1 6.4±3.5, Q2 7.9±4.1, Q3 8.2±4.1, Q4 8.1±4.4), desaturation (Q1 95.3±3.7, Q2 94.4±3.1%, Q3 91.7±4.8%, Q4 86.5±9.1%), alterations of inflammatory markers, hospital stay (Q1 6.4±2.9, Q2 7.4±4.1, Q3 9.6±5.8, Q4 13.1±10.4 days), admission to ICU (Q1-2.5%, Q2-5.8%, Q3-12.5%, Q4-49.1%), mortality (Q1-3.8%, Q2-4.5%, Q3-9.4%, Q4-33.3%), mixed CT lesions (ground glass opacity-consolidation), linear opacities, crazy-paving pattern, reverse halo sign, and
bronchiectasis. The total CT score significantly correlated with leukocyte, neutrophil and lymphocyte counts, and with other inflammatory markers. Semi-quantitative evaluation of pulmonary involvement in the initial chest CT can help to establish the severity of the case and predict relevant clinical outcomes in COVID-19 patients.

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