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

Is lung density associated with severity of COVID-19?

Keno K. Bressem
1
,
Lisa C. Adams
1
,
Jakob Albrecht
1
,
Antonie Petersen
1
,
Hans-Martin Thieß
1
,
Alexandra Niehues
1
,
Stefan M. Niehues
1
,
Janis L. Vahldiek
1

1.
Charité – Universitätsmedizin Berlin, Berlin, Germany
Pol J Radiol 2020; 85: e600-e606
Online publish date: 2020/10/30
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Introduction
Emphysema and chronic obstructive lung disease were previously identified as major risk factors for severe disease progression in COVID-19. Computed tomography (CT)-based lung-density analysis offers a fast, reliable, and quantitative assessment of lung density. Therefore, we aimed to assess the benefit of CT-based lung density measurements to predict possible severe disease progression in COVID-19.

Material and methods
Thirty COVID-19-positive patients were included in this retrospective study. Lung density was quantified based on routinely acquired chest CTs. Presence of COVID-19 was confirmed by reverse transcription polymerase chain reaction (RT-PCR). Wilcoxon test was used to compare two groups of patients. A multivariate regression analysis, adjusted for age and sex, was employed to model the relative increase of risk for severe disease, depending on the measured densities.

Results
Intensive care unit (ICU) patients or patients requiring mechanical ventilation showed a lower proportion of medium- and low-density lung volume compared to patients on the normal ward, but a significantly larger volume of high-density lung volume (12.26 dl IQR 4.65 dl vs. 7.51 dl vs. IQR 5.39 dl, p = 0.039). In multivariate regression analysis, high-density lung volume was identified as a significant predictor of severe disease.

Conclusions
The amount of high-density lung tissue showed a significant association with severe COVID-19, with odds ratios of 1.42 (95% CI: 1.09-2.00) and 1.37 (95% CI: 1.03-2.11) for requiring intensive care and mechanical ventilation, respectively. Acknowledging our small sample size as an important limitation; our study might thus suggest that high-density lung tissue could serve as a possible predictor of severe COVID-19.

keywords:

CT scan, spiral CT, SARS Coronavirus, SARS-CoV

 
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