Journal Article

Association of chest computed tomography severity score at ICU admission and respiratory outcomes in critically ill COVID-19 patients

Mori, Andréia L., Radermacher, Peter, Barlem Hohmann, Fábio, S. Carvalho, André, Esper Treml, Ricardo, Filho, Pedro Hilton A., A. T. Dall-Aglio, Pedro, S. F. Serrano, Juliana, Lima da Rocha, Daniel, Silva, João M., Caldonazo, Tulio

2024

Overview

To evaluate the association of a validated chest computed tomography (Chest-CT) severity score in COVID-19 patients with their respiratory outcome in the Intensive Care Unit. A single-center, prospective study evaluated patients with positive RT-PCR for COVID-19, who underwent Chest-CT and had a final COVID-19 clinical diagnosis needing invasive mechanical ventilation in the ICU. The admission chest-CT was evaluated according to a validated Chest-CT Severity Score in COVID-19 (Chest-CTSS) divided into low ≤50% (<14 points) and >50% high (≥14 points) lung parenchyma involvement. The association between the initial score and their pulmonary clinical outcomes was evaluated. 121 patients were clustered into the > 50% lung involvement group and 105 patients into the ≤ 50% lung involvement group. Patients ≤ 50% lung involvement (<14 points) group presented lower PEEP levels and FiO2 values, respectively GEE P = 0.09 and P = 0.04. The adjusted COX model found higher hazard to stay longer on invasive mechanical ventilation HR: 1.69, 95% CI, 1.02-2.80, P = 0.042 and the adjusted logistic regression model showed increased risk ventilator-associated pneumonia OR = 1.85 95% CI 1.01-3.39 for COVID-19 patients with > 50% lung involvement (≥14 points) on Chest-CT at ICU admission. COVID-19 patients with >50% lung involvement on Chest-CT admission presented higher chances to stay longer on invasive mechanical ventilation and more chances to developed ventilator-associated pneumonia.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Aged / Biology and Life Sciences / Care and treatment / Chest / Computed tomography / COVID-19 / COVID-19 - diagnostic imaging / COVID-19 - therapy / Creatinine / Critical Illness / Critically ill / CT imaging / Ethics / Evaluation / Female / Hemoglobin / Humans / Infections / Intensive Care Units / Laboratories / Lung - diagnostic imaging / Lungs / Male / Mechanical ventilation / Medical imaging / Medical research / Medicine and Health Sciences / Medicine, Experimental / Middle Aged / Observational studies / Parenchyma / Physical Sciences / Pneumonia / Prospective Studies / Regression analysis / Regression models / Research and Analysis Methods / Respiration, Artificial / SARS-CoV-2 - isolation & purification / Severe acute respiratory syndrome coronavirus 2 / Severity of Illness Index / Survival analysis / Tomography / Tomography, X-Ray Computed / Variables / Ventilation / Ventilator-associated pneumonia / Ventilators