tetano
Editor, Senior Moderator
Eur J Radiol
. 2020 Sep 9;131:109271.
doi: 10.1016/j.ejrad.2020.109271. Online ahead of print.
The prognostic value of pneumonia severity score and pectoralis muscle Area on chest CT in adult COVID-19 patients
Furkan Ufuk[SUP] 1 [/SUP], Mahmut Demirci[SUP] 2 [/SUP], Ergin Sagtas[SUP] 2 [/SUP], Ismail Hakkı Akbudak[SUP] 3 [/SUP], Erhan Ugurlu[SUP] 4 [/SUP], Tugba Sari[SUP] 5 [/SUP]
Affiliations
Abstract
Purpose: To assess the prognostic value of pneumonia severity score (PSS), pectoralis muscle area (PMA), and index (PMI) on chest computed tomography (CT) in adult coronavirus disease 2019 (COVID-19) patients.
Method: The chest CT images of COVID-19 patients were evaluated for the PSS as the ratio of the volume of involved lung parenchyma to the total lung volume. The cross-sectional areas of the pectoralis muscles (PMA, cm[SUP]2[/SUP]) were also measured automatically on axial CT images, and PMI was calculated as the following formula: PMI = PMA / patient's height square (m[SUP]2[/SUP]). The relationship between clinical variables, PSS, PMA, sex-specific PMI values, and patient outcomes (intubation, prolonged hospital stay, and death) were investigated using multivariable logistic regression analysis. All patients were followed for more than a month.
Results: One-hundred thirty patients (76 males, 58.46 %) were included in the study. Fifteen patients (11.54 %) were intubated, 24 patients (18.46 %) had prolonged hospital stay, and eight patients (6.15 %) died during follow-up. Patients with comorbidity had a higher mean of PSS (6.3 + 4.5 vs 3.9 + 3.8; p = 0.001). After adjusting the confounders, PSS was an independent predictor of intubation (adjusted Odds Ratio [OR]: 1.73, 95 % CI 1.31-2.28, p < 0.001), prolonged hospital stay (OR: 1.20, 95 % CI 1.09-1.33, p < 0.001), and death (OR: 2.13, 95 % CI 1.1-4.13, p = 0.026. PMI value was a predictor of prolonged hospital stay (OR: 0.83, 95 % CI 0.72-0.96, p = 0.038) and death (OR: 0.53, 95 % CI 0.29-0.96, p = 0.036). Incrementally increasing PMA value was a predictor of prolonged hospital stay (OR: 0.93, 95 % CI 0.89-0.98, p = 0.01) and intubation (OR: 0.98, 95 % CI 0.96-1, p = 0.036).
Conclusion: PSS, PMA, and PMI values have prognostic value in adult COVID-19 patients and can be easily assessed on chest CT images.
Keywords: COVID-19; Computed tomography; Pneumonia; Prognosis; Sarcopenia.
. 2020 Sep 9;131:109271.
doi: 10.1016/j.ejrad.2020.109271. Online ahead of print.
The prognostic value of pneumonia severity score and pectoralis muscle Area on chest CT in adult COVID-19 patients
Furkan Ufuk[SUP] 1 [/SUP], Mahmut Demirci[SUP] 2 [/SUP], Ergin Sagtas[SUP] 2 [/SUP], Ismail Hakkı Akbudak[SUP] 3 [/SUP], Erhan Ugurlu[SUP] 4 [/SUP], Tugba Sari[SUP] 5 [/SUP]
Affiliations
- PMID: 32942198
- DOI: 10.1016/j.ejrad.2020.109271
Abstract
Purpose: To assess the prognostic value of pneumonia severity score (PSS), pectoralis muscle area (PMA), and index (PMI) on chest computed tomography (CT) in adult coronavirus disease 2019 (COVID-19) patients.
Method: The chest CT images of COVID-19 patients were evaluated for the PSS as the ratio of the volume of involved lung parenchyma to the total lung volume. The cross-sectional areas of the pectoralis muscles (PMA, cm[SUP]2[/SUP]) were also measured automatically on axial CT images, and PMI was calculated as the following formula: PMI = PMA / patient's height square (m[SUP]2[/SUP]). The relationship between clinical variables, PSS, PMA, sex-specific PMI values, and patient outcomes (intubation, prolonged hospital stay, and death) were investigated using multivariable logistic regression analysis. All patients were followed for more than a month.
Results: One-hundred thirty patients (76 males, 58.46 %) were included in the study. Fifteen patients (11.54 %) were intubated, 24 patients (18.46 %) had prolonged hospital stay, and eight patients (6.15 %) died during follow-up. Patients with comorbidity had a higher mean of PSS (6.3 + 4.5 vs 3.9 + 3.8; p = 0.001). After adjusting the confounders, PSS was an independent predictor of intubation (adjusted Odds Ratio [OR]: 1.73, 95 % CI 1.31-2.28, p < 0.001), prolonged hospital stay (OR: 1.20, 95 % CI 1.09-1.33, p < 0.001), and death (OR: 2.13, 95 % CI 1.1-4.13, p = 0.026. PMI value was a predictor of prolonged hospital stay (OR: 0.83, 95 % CI 0.72-0.96, p = 0.038) and death (OR: 0.53, 95 % CI 0.29-0.96, p = 0.036). Incrementally increasing PMA value was a predictor of prolonged hospital stay (OR: 0.93, 95 % CI 0.89-0.98, p = 0.01) and intubation (OR: 0.98, 95 % CI 0.96-1, p = 0.036).
Conclusion: PSS, PMA, and PMI values have prognostic value in adult COVID-19 patients and can be easily assessed on chest CT images.
Keywords: COVID-19; Computed tomography; Pneumonia; Prognosis; Sarcopenia.