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1/2023
vol. 88 Chest radiology
abstract:
Original paper
Chest computed tomography of suspected COVID-19 pneumonia in the Emergency Department: comparative analysis between patients with different vaccination status
Luca Alessandro Carbonaro
1, 2
,
Francesca Braga
3
,
Pietro Gemma
1, 4
,
Eleonora Carlicchi
1, 4
,
Annamaria Pata
,
Martina Conca
,
Francesco Rizzetto
,
Angelo Vanzulli
1.
Department of Radiology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
2.
Department of Oncology and Haemato-oncology, University of Milan, Milan, Italy
3.
Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Milan, Italy
4.
Postgraduation School of Diagnostic and Interventional Radiology, University of Milan, Milan, Italy
© Pol J Radiol 2023; 88: e80-e88
Online publish date: 2023/02/06
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Introduction
To identify differences in chest computed tomography (CT) of the symptomatic coronavirus disease 2019 (COVID-19) population according to the patients’ severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination status (non-vaccinated, vaccinated with incomplete or complete vaccination cycle). Material and methods CT examinations performed in the Emergency Department (ED) in May-November 2021 for suspected COVID-19 pneumonia with a positive SARS-CoV-2 test were retrospectively included. Personal data were compared for vaccination status. One 13-year experienced radiologist and two 4th-year radiology residents independently evaluated chest CT scans according to CO-RADS and ACR COVID classifications. In possible COVID-19 pneumonia cases, defined as CO-RADS 3 to 5 (ACR indeterminate and typical) by each reader, high involvement CT score (≥ 25%) and CT patterns (presence of ground glass opacities, consolidations, crazy paving areas) were compared for vaccination status. Results 184 patients with known vaccination status were included in the analysis: 111 non-vaccinated (60%) for SARS-CoV-2 infection, 21 (11%) with an incomplete vaccination cycle, and 52 (28%) with a complete vaccination cycle (6 different vaccine types). Multivariate logistic regression showed that the only factor predicting the absence of pneumonia (CO-RADS 1 and ACR negative cases) for the 3 readers was a complete vaccination cycle (OR = 12.8-13.1 compared to non-vaccinated patients, p ≤ 0.032). Neither CT score nor CT patterns of possible COVID-19 pneumonia showed any statistically significant correlation with vaccination status for the 3 readers. Conclusions Symptomatic SARS-CoV-2-infected patients with a complete vaccination cycle had much higher odds of showing a negative CT chest examination in ED compared to non-vaccinated patients. Neither CT involvement nor CT patterns of interstitial pneumonia showed differences across different vaccination status. keywords:
computed tomography, COVID-19, SARS-CoV-2, vaccination, pneumonia |
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