tetano
Editor, Senior Moderator
BMC Pulm Med
. 2025 Dec 1;25(1):550.
doi: 10.1186/s12890-025-04030-z. Consolidation-to-ground-glass opacity ratio on chest CT as a prognostic marker for critical outcomes in COVID-19: a retrospective cohort study
Hiromu Tanaka[SUP] #[/SUP][SUP] 1 [/SUP], Naoya Tanabe[SUP] #[/SUP][SUP] 2 [/SUP], Shotaro Chubachi[SUP] 3 4 [/SUP], Tomoki Maetani[SUP] 2 [/SUP], Yusuke Shiraishi[SUP] 2 [/SUP], Ho Namkoong[SUP] 5 [/SUP], Takanori Asakura[SUP] 1 6 7 [/SUP], Takashi Shimada[SUP] 1 [/SUP], Shuhei Azekawa[SUP] 1 [/SUP], Shiro Otake[SUP] 1 [/SUP], Kensuke Nakagawara[SUP] 1 [/SUP], Takahiro Fukushima[SUP] 1 [/SUP], Mayuko Watase[SUP] 1 [/SUP], Hideki Terai[SUP] 1 [/SUP], Mamoru Sasaki[SUP] 8 [/SUP], Soichiro Ueda[SUP] 8 [/SUP], Yukari Kato[SUP] 9 [/SUP], Norihiro Harada[SUP] 9 [/SUP], Shoji Suzuki[SUP] 10 [/SUP], Shuichi Yoshida[SUP] 10 [/SUP], Hiroki Tateno[SUP] 10 [/SUP], Yoshitake Yamada[SUP] 11 [/SUP], Masahiro Jinzaki[SUP] 11 [/SUP], Toyohiro Hirai[SUP] 2 [/SUP], Yukinori Okada[SUP] 12 13 14 [/SUP], Ryuji Koike[SUP] 15 [/SUP], Makoto Ishii[SUP] 1 16 [/SUP], Naoki Hasegawa[SUP] 5 [/SUP], Akinori Kimura[SUP] 17 [/SUP], Seiya Imoto[SUP] 18 [/SUP], Satoru Miyano[SUP] 19 [/SUP], Seishi Ogawa[SUP] 20 21 [/SUP], Takanori Kanai[SUP] 22 [/SUP], Koichi Fukunaga[SUP] 1 [/SUP]
Affiliations
Background: Computed tomography (CT)-based quantification of coronavirus disease 2019 (COVID-19) pneumonia is widely performed, and total pneumonia volume, ground-glass opacity (GGO), and consolidation affect disease severity. However, there is insufficient information on how consolidation to GGO (C/G) ratio correlates with clinical characteristics including disease severity and complications in COVID-19 patients.
Methods: This retrospective cohort study included 1,194 hospitalized patients with COVID-19 from four member hospitals of the Japan COVID-19 Task Force. Critical outcomes were defined as conditions requiring high-flow oxygen or invasive mechanical ventilation, or death. Patients were divided into two groups based on %pneumonia (percentage of pneumonia volume divided by total lung volume) using receiver operating characteristic curve, and those with high %pneumonia were further divided into two groups based on C/G ratio. Critical outcomes and complications were then compared between high and low C/G ratio groups.
Results: The optimal cutoff value of %pneumonia to predict critical outcomes was 17.1%, classifying the included patients into low (Group 1, n = 900) and high (n = 294) %pneumonia groups. The optimal cutoff value of C/G ratio was 0.202, classifying patients in the high %pneumonia group into two groups: low (Group 2, n = 192) and high C/G (Group 3, n = 102) ratio groups. The incidence of critical outcomes was stair-step high in all three groups (2.1%, 21.4%, and 37.3%, respectively). Multivariable analysis revealed an independent relationship between C/G ratio and critical outcomes from other known risk factors (adjusted odds ratio: 1.92, 95% confidential interval: 1.03-3.59, P = 0.040). Group 3 also showed significantly higher serum C-reactive protein (Group 1: 2.96 mg/dL, Group 2: 8.90 mg/dL, Group 3: 11.4 mg/dL) and procalcitonin (Group 1: 0.16 ng/mL, Group 2: 0.25 ng/mL, Group 3: 1.19 ng/mL) levels and incidence of bacterial infection (Group 1: 5.6%, Group 2: 10.4%, Group 3: 20.3%), compared with other groups.
Conclusions: CT-density analysis of COVID-19 pneumonia in a large patient population showed that C/G ratio was a significant predictor of critical outcomes and useful for prognosis evaluation.
Keywords: Biomarker; CT density analysis; Consolidation-to-ground glass opacity ratio; Coronavirus disease 2019; Prognostic prediction.
. 2025 Dec 1;25(1):550.
doi: 10.1186/s12890-025-04030-z. Consolidation-to-ground-glass opacity ratio on chest CT as a prognostic marker for critical outcomes in COVID-19: a retrospective cohort study
Hiromu Tanaka[SUP] #[/SUP][SUP] 1 [/SUP], Naoya Tanabe[SUP] #[/SUP][SUP] 2 [/SUP], Shotaro Chubachi[SUP] 3 4 [/SUP], Tomoki Maetani[SUP] 2 [/SUP], Yusuke Shiraishi[SUP] 2 [/SUP], Ho Namkoong[SUP] 5 [/SUP], Takanori Asakura[SUP] 1 6 7 [/SUP], Takashi Shimada[SUP] 1 [/SUP], Shuhei Azekawa[SUP] 1 [/SUP], Shiro Otake[SUP] 1 [/SUP], Kensuke Nakagawara[SUP] 1 [/SUP], Takahiro Fukushima[SUP] 1 [/SUP], Mayuko Watase[SUP] 1 [/SUP], Hideki Terai[SUP] 1 [/SUP], Mamoru Sasaki[SUP] 8 [/SUP], Soichiro Ueda[SUP] 8 [/SUP], Yukari Kato[SUP] 9 [/SUP], Norihiro Harada[SUP] 9 [/SUP], Shoji Suzuki[SUP] 10 [/SUP], Shuichi Yoshida[SUP] 10 [/SUP], Hiroki Tateno[SUP] 10 [/SUP], Yoshitake Yamada[SUP] 11 [/SUP], Masahiro Jinzaki[SUP] 11 [/SUP], Toyohiro Hirai[SUP] 2 [/SUP], Yukinori Okada[SUP] 12 13 14 [/SUP], Ryuji Koike[SUP] 15 [/SUP], Makoto Ishii[SUP] 1 16 [/SUP], Naoki Hasegawa[SUP] 5 [/SUP], Akinori Kimura[SUP] 17 [/SUP], Seiya Imoto[SUP] 18 [/SUP], Satoru Miyano[SUP] 19 [/SUP], Seishi Ogawa[SUP] 20 21 [/SUP], Takanori Kanai[SUP] 22 [/SUP], Koichi Fukunaga[SUP] 1 [/SUP]
Affiliations
- PMID: 41327196
- DOI: 10.1186/s12890-025-04030-z
Background: Computed tomography (CT)-based quantification of coronavirus disease 2019 (COVID-19) pneumonia is widely performed, and total pneumonia volume, ground-glass opacity (GGO), and consolidation affect disease severity. However, there is insufficient information on how consolidation to GGO (C/G) ratio correlates with clinical characteristics including disease severity and complications in COVID-19 patients.
Methods: This retrospective cohort study included 1,194 hospitalized patients with COVID-19 from four member hospitals of the Japan COVID-19 Task Force. Critical outcomes were defined as conditions requiring high-flow oxygen or invasive mechanical ventilation, or death. Patients were divided into two groups based on %pneumonia (percentage of pneumonia volume divided by total lung volume) using receiver operating characteristic curve, and those with high %pneumonia were further divided into two groups based on C/G ratio. Critical outcomes and complications were then compared between high and low C/G ratio groups.
Results: The optimal cutoff value of %pneumonia to predict critical outcomes was 17.1%, classifying the included patients into low (Group 1, n = 900) and high (n = 294) %pneumonia groups. The optimal cutoff value of C/G ratio was 0.202, classifying patients in the high %pneumonia group into two groups: low (Group 2, n = 192) and high C/G (Group 3, n = 102) ratio groups. The incidence of critical outcomes was stair-step high in all three groups (2.1%, 21.4%, and 37.3%, respectively). Multivariable analysis revealed an independent relationship between C/G ratio and critical outcomes from other known risk factors (adjusted odds ratio: 1.92, 95% confidential interval: 1.03-3.59, P = 0.040). Group 3 also showed significantly higher serum C-reactive protein (Group 1: 2.96 mg/dL, Group 2: 8.90 mg/dL, Group 3: 11.4 mg/dL) and procalcitonin (Group 1: 0.16 ng/mL, Group 2: 0.25 ng/mL, Group 3: 1.19 ng/mL) levels and incidence of bacterial infection (Group 1: 5.6%, Group 2: 10.4%, Group 3: 20.3%), compared with other groups.
Conclusions: CT-density analysis of COVID-19 pneumonia in a large patient population showed that C/G ratio was a significant predictor of critical outcomes and useful for prognosis evaluation.
Keywords: Biomarker; CT density analysis; Consolidation-to-ground glass opacity ratio; Coronavirus disease 2019; Prognostic prediction.