E-ISSN: 1305-3612
    Predictive value of CT imaging findings in COVID-19 pneumonia at the time of first-screen regarding the need for hospitalization or intensive care unit
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    Chest Imaging - Original Article
    VOLUME: 27 ISSUE: 5
    P: 599-606
    September 2021

    Predictive value of CT imaging findings in COVID-19 pneumonia at the time of first-screen regarding the need for hospitalization or intensive care unit

    Diagn Interv Radiol 2021;27(5):599-606
    DOI: 10.5152/dir.2020.20421
    Deniz Esin Tekcan Sanli 1
    Duzgun Yildirim 2
    Ahmet Necati Sanli 3
    Neval Erozan 1
    Guray Husmen 1
    Aytug Altundag 4
    Filiz Tuzuner 5
    Oner Dikensoy 6
    Ceyda Erel Kirisoglu 7
    1. Department of Radiology, Acibadem Kozyatagi Hospital, Istanbul, Turkey
    2. Department of Radiology, Acibadem Taksim Hospital, Istanbul, Turkey
    3. Department of General Surgery, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
    4. Department of Otolaryngology, Acibadem Taksim Hospital, Istanbul, Turkey
    5. Department of Anestesiology, Acibadem Taksim Hospital, Istanbul, Turkey
    6. Department of Pulmonary Medicine, Acibadem Taksim Hospital, Istanbul, Turkey
    7. Department of Pulmonary Medicine, Acibadem Kozyatagi Hospital, Istanbul, Turkey
    No information available.
    No information available
    Received Date: 04.06.2020
    Accepted Date: 15.09.2020
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    ABSTRACT

    PURPOSE

    In this study, we aimed to reveal the relationship between initial lung parenchymal involvement patterns and the subsequent need for hospitalization and/or intensive care unit admission in coronavirus disease 2019 (COVID-19) positive cases.

    METHODS

    Overall, 231 patients diagnosed with COVID-19 as proven by PCR were included in this study. Based on the duration of hospitalization, patients were divided into three groups as follows: Group 1, patients receiving outpatient treatment or requiring hospitalization <7 days; Group 2, requiring hospitalization ≥7 days; Group 3, patients requiring at least 1 day of intensive care at any time. Chest CT findings at first admission were evaluated for the following features: typical/atypical involvement of the disease, infiltration patterns (ground-glass opacities, crazy-paving pattern, consolidation), distribution and the largest diameters of the lesions, total lesion numbers, number of affected lung lobes, and affected total lung parenchyma percentages. The variability of all these findings according to the groups was analyzed statistically.

    RESULTS

    In this study, 172 patients were in Group 1, 39 patients in Group 2, and 20 patients in Group 3. The findings obtained in this study indicated that there was no statistically significant difference in ground-glass opacity rates among the groups (p = 0.344). The rates of crazy-paving and consolidation patterns were significantly higher in Groups 2 and 3 than in Group 1 (p = 0.001, p = 0.002, respectively). The rate of right upper, left upper lobe, and right middle lobe involvements as consolidation pattern was significantly higher in Group 3 than in Group 1 (p = 0.148, p = 0.935, p = 0.143, respectively). A statistically significant difference was also found between the affected lobe numbers, total lesion numbers, the diameter of the largest lesion, and the affected lung parenchyma percentages between the groups (p = 0.001). The average number of impacted lobes in Group 1 was 2; 4 in Group 2 and Group 3. The mean percentage of affected lung parenchyma percentage was 25% in Group 1 and Group 2, and 50% in Group 3.

    CONCLUSION

    In case of infiltration dominated by right middle or upper lobe involvement with a consolidation pattern, there is a higher risk of future intensive care need. Also, the need for intensive care increases as the number of affected lobes and percentage of affected parenchymal involvement increase.

    References

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