Journal article
COVID-19 pneumonia in the emergency department: correlation of initial chest CT findings with short-term outcome
Emergency radiology, Vol.27(6), pp.691-699
12/01/2020
DOI: 10.1007/s10140-020-01863-5
PMCID: PMC7561434
PMID: 33063178
Abstract
Evaluate chest computed tomography (CT) findings of laboratory-confirmed Coronavirus Disease 2019 (COVID-19) cases and correlate it with clinical and laboratorial signs of severe disease and short-term outcome.
Chest CTs of 61 consecutive cases of COVID-19 disease that attended in our emergency department (ED) were reviewed. Three groups of patients classified according to the short-term follow-up were compared: (1) early-discharged from ED, (2) hospitalized on regular wards, and (3) admitted to intensive care unit (ICU). CT findings were also correlated with clinical and laboratorial features associated with severe disease.
Median age was 52 years (IQR 39-63) with male predominance (60.7%). Most of the patients that did not require hospitalization had parenchymal involvement of less than 25% on CT (84.6%). Among hospitalized patients, interlobular septal thickening and extensive lung disease (> 50% of parenchyma) were significantly more frequent in ICU-admitted patients (P = 0.018 and P = 0.043, respectively). Interlobular septal thickening also correlated with longer ICU stay (P = 0.018). Low oxygen saturation (SpO
≤ 93%) was associated with septal thickening (P = 0.004), diffuse distribution (P = 0.016), and pleural effusion (P = 0.037) on CT. All patients with > 50% of parenchymal involvement showed SpO
≤ 93%. Elevated C-reactive protein (CRP) levels (> 5.0 mg/dL) correlated with consolidation (P = 0.002), septal thickening (P = 0.018), diffuse distribution (P = 0.020), and more extensive parenchymal involvement (P = 0.017).
Interlobular septal thickening on CT was associated with ICU admission and longer stay on ICU. Diffuse distribution, septal thickening, and more extensive lung involvement correlated with lower SpO
and higher CRP levels. Patients that needed hospitalization and ICU admission presented more extensive lung disease on CT.
Details
- Title: Subtitle
- COVID-19 pneumonia in the emergency department: correlation of initial chest CT findings with short-term outcome
- Creators
- Camila Silva Barbosa - Hospital Sírio-LibanêsGuilherme Wilson Otaviano Garcia Chaves - Hospital Sírio-LibanêsCamila Vilela de Oliveira - Hospital Sírio-LibanêsGuilherme Hipolito Bachion - Hospital Sírio-LibanêsChang Kai Chi - Hospital São PauloGiovanni Guido Cerri - Hospital Sírio-LibanêsThais Carneiro Lima - Hospital Sírio-LibanêsHye Ju Lee - Hospital Sírio-Libanês
- Resource Type
- Journal article
- Publication Details
- Emergency radiology, Vol.27(6), pp.691-699
- DOI
- 10.1007/s10140-020-01863-5
- PMID
- 33063178
- PMCID
- PMC7561434
- NLM abbreviation
- Emerg Radiol
- ISSN
- 1070-3004
- eISSN
- 1438-1435
- Language
- English
- Date published
- 12/01/2020
- Academic Unit
- Radiology
- Record Identifier
- 9984746240902771
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