Diagnostic and Interventional Radiology
Chest Imaging - Original Article

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

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

Diagn Interv Radiol 2020; 1: -
DOI: 10.5152/dir.2020.20421
Read: 1705 Downloads: 256 Published: 02 December 2020

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.

 

You may cite this article as: Tekcan Sanli DE, Yildirim D, Sanli AN, et al. 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 2 December 2020 10.5152/dir.2020.20421 [Epub Ahead of Print]

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