ISSN: 1899-0967
Polish Journal of Radiology
Established by prof. Zygmunt Grudziński in 1926 Sun
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1/2020
vol. 85
 
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Chest radiology
abstract:
Original paper

Chest computed tomography signs associated with pejorative evolution in COVID-19 patients

Romain Auger
1
,
Paul-Armand Dujardin
2
,
Aurore Bleuzen
1
,
Juliette Buraschi
1
,
Natacha Mandine
1
,
Sylvain Marchand-Adam
3
,
Arthur Pearson
1
,
Gaëlle Derot
1

1.
Department of Radiology, Centre Hospitalier Régional Universitaire de Tours, France
2.
CIC 1415, Centre Hospitalier Régional Universitaire de Tours, Inserm, Tours Cedex, France
3.
Department of Respiratory Medecine, Centre Hospitalier Régional Universitaire de Tours, France
© Pol J Radiol 2020; 85: e115-e121
Online publish date: 2021/02/20
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Introduction
The aim of this study was to evaluate how chest computed tomography (CT) can predict pejorative evolution in COVID-19 patients.

Material and methods
Data on 349 consecutive patients who underwent a chest CT either for severe suspected COVID-19 pneumonia or clinical aggravation and with COVID-19 were retrospectively analysed. In total, 109 had laboratory-confirmed COVID-19 infection by a positive reverse-transcription polymerase chain reaction (RT-PCR) and were included. The main outcomes for pejorative evolution were death and the need for invasive endotracheal ventilation (IEV). All the CT images were retrospectively reviewed, to analyse the CT signs and semiologic patterns of pulmonary involvement.

Results
Among the 109 COVID-19 patients, 73 (67%) had severe symptoms of COVID-19, 28 (25.7%) needed an IEV, and 11 (10.1%) died. The following signs were significantly associated with both mortality and need for IEV: traction bronchiectasis and total affected lung volume ≥ 50% (p < 10–3). Other CT signs were only associated with the need of IEV: vascular dilatation, air bubble sign, peribronchovascular thickening, interlobular thickening, and number of involved lobes ≥ 4 (p < 10–3).

Conclusions
On a chest CT performed during the first week of the symptoms, the presence of traction bronchiectasis and high values of affected lung volume are associated with the need for IEV, and with mortality, in COVID-19 patients.

keywords:

COVID-19, chest CT, IEV, critical care, bronchiectasis




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