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Erschienen in: Wiener Medizinische Wochenschrift 3-4/2022

08.02.2022 | original article

Chest CT severity score: assessment of COVID‑19 severity and short-term prognosis in hospitalized Iranian patients

verfasst von: Alireza Aziz-Ahari, Mahsa Keyhanian, Setareh Mamishi, Shima Mahmoudi, Ebrahim Ebrahimi Bastani, Fatemeh Asadi, Mohammadreza Khaleghi

Erschienen in: Wiener Medizinische Wochenschrift | Ausgabe 3-4/2022

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Summary

Background

The aim of this study was to evaluate the value of chest computed tomography (CT) severity score in the assessment of coronavirus disease 2019 (COVID‑19) severity and short-term prognosis.

Methods

In this cross-sectional study, we evaluated all patients who were referred to our university hospital, from 21 May 2020 to 22 June 2020 with positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription-polymerase chain reaction (RT-PCR) test. The patients suspected of having other respiratory diseases including influenza, according to an infectious disease specialist, and those without chest CT scan were excluded. A chest CT was obtained for all patients between days 4 and 7 days after symptom onset. Chest CT severity score was also calculated based on the degree of involvement of the lung lobes as 0%, (0 points), 1–25% (1 point), 26–50% (2 points), 51–75% (3 points), and 76–100% (4 points). The CT severity score was quantified by summing the 5 lobe indices (range 0–20). The ROC curve analysis was performed for the clinical value of CT scores in distinguishing the patients based on the severity of disease (mild/moderate group versus severe group), ICU admission, intubation requirement, and mortality.

Results

Of the 148 patients included, 93 patients recovered, while 55 patients died (mortality rate 37%). The area under the curve of CT score for discriminating of recovered patients from deceased individuals was 0.726, and the optimal CT score threshold was 15.5 with 61.8% sensitivity and 76.3% specificity. The best CT score cut-off for discriminating of patients based on the severity of disease was 12.5 with 68.3% sensitivity and 72.7% specificity. In addition, with CT score cut-off of 15.5, sensitivities of 70.8% and 51.6% and specificities of 78% and 72.6% were observed for intubation and ICU admission, respectively.

Conclusion

CT scan and semiquantitative scoring method could be beneficial and applicable in predicting the patient’s condition.
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Metadaten
Titel
Chest CT severity score: assessment of COVID‑19 severity and short-term prognosis in hospitalized Iranian patients
verfasst von
Alireza Aziz-Ahari
Mahsa Keyhanian
Setareh Mamishi
Shima Mahmoudi
Ebrahim Ebrahimi Bastani
Fatemeh Asadi
Mohammadreza Khaleghi
Publikationsdatum
08.02.2022
Verlag
Springer Vienna
Erschienen in
Wiener Medizinische Wochenschrift / Ausgabe 3-4/2022
Print ISSN: 0043-5341
Elektronische ISSN: 1563-258X
DOI
https://doi.org/10.1007/s10354-022-00914-5