Theranostics Association of Clinical and Radiographic Findings With the Outcomes of 93 Patients With COVID-19 in Wuhan, China

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Theranostics


. 2020 May 15;10(14):6113-6121.
doi: 10.7150/thno.46569. eCollection 2020.
Association of Clinical and Radiographic Findings With the Outcomes of 93 Patients With COVID-19 in Wuhan, China


Lingli Li ^{1 2} , Lian Yang ^{1 2} , Shan Gui ^{1 2} , Feng Pan ^{1 2} , Tianhe Ye ^{1 2} , Bo Liang ^{1 2} , Yu Hu ³ , Chuansheng Zheng ^{1 2}



Affiliations

• PMID: 32483442
• PMCID: PMC7255034
• DOI: 10.7150/thno.46569

Abstract

Rationale: To retrospectively analyze serial chest CT and clinical features in patients with coronavirus disease 2019 (COVID-19) for the assessment of temporal changes and to investigate how the changes differ in survivors and nonsurvivors. Methods: The consecutive records of 93 patients with confirmed COVID-19 who were admitted to Wuhan Union Hospital from January 10, 2020, to February 22, 2020, were retrospectively reviewed. A series of chest CT findings and clinical data were collected and analyzed. The serial chest CT scans were scored on a semiquantitative basis according to the extent of pulmonary abnormalities. Chest CT scores in different periods (0 - 5 days, 6 - 10 days, 11 - 15 days, 16 - 20 days, and > 20 days) since symptom onset were compared between survivors and nonsurvivors, and the temporal trend of the radiographic-clinical features was analyzed. Results: The final cohort consisted of 93 patients: 68 survivors and 25 nonsurvivors. Nonsurvivors were significantly older than survivors. For both survivors and nonsurvivors, the chest CT scores were not different in the first period (0 - 5 days) but diverged afterwards. The mortality rate of COVID-19 monotonously increased with chest CT scores, which positively correlated with the neutrophil-to-lymphocyte ratio, neutrophil percentage, D-dimer level, lactate dehydrogenase level and erythrocyte sedimentation rate, while negatively correlated with the lymphocyte percentage and lymphocyte count. Conclusions: Chest CT scores correlate well with risk factors for mortality over periods, thus they may be used as a prognostic indicator in COVID-19. While higher chest CT scores are associated with a higher mortality rate, CT images taken at least 6 days since symptom onset may contain more prognostic information than images taken at an earlier period.

Keywords: COVID-19; Outcome; Viral Pneumonia; X-Ray Computed Tomography.