tetano
Editor, Senior Moderator
PLoS One
. 2024 May 2;19(5):e0299390.
doi: 10.1371/journal.pone.0299390. eCollection 2024. Association of chest computed tomography severity score at ICU admission and respiratory outcomes in critically ill COVID-19 patients
Ricardo Esper Treml[SUP] 1 2 [/SUP], Tulio Caldonazo[SUP] 3 [/SUP], Fábio Barlem Hohmann[SUP] 4 [/SUP], Daniel Lima da Rocha[SUP] 4 [/SUP], Pedro Hilton A Filho[SUP] 5 [/SUP], Andréia L Mori[SUP] 5 [/SUP], André S Carvalho[SUP] 5 [/SUP], Juliana S F Serrano[SUP] 5 [/SUP], Pedro A T Dall-Aglio[SUP] 5 [/SUP], Peter Radermacher[SUP] 6 [/SUP], João M Silva Jr[SUP] 2 4 5 [/SUP]
Affiliations
Objective: 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.
Methods: 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.
Results: 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.
Conclusion: 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.
. 2024 May 2;19(5):e0299390.
doi: 10.1371/journal.pone.0299390. eCollection 2024. Association of chest computed tomography severity score at ICU admission and respiratory outcomes in critically ill COVID-19 patients
Ricardo Esper Treml[SUP] 1 2 [/SUP], Tulio Caldonazo[SUP] 3 [/SUP], Fábio Barlem Hohmann[SUP] 4 [/SUP], Daniel Lima da Rocha[SUP] 4 [/SUP], Pedro Hilton A Filho[SUP] 5 [/SUP], Andréia L Mori[SUP] 5 [/SUP], André S Carvalho[SUP] 5 [/SUP], Juliana S F Serrano[SUP] 5 [/SUP], Pedro A T Dall-Aglio[SUP] 5 [/SUP], Peter Radermacher[SUP] 6 [/SUP], João M Silva Jr[SUP] 2 4 5 [/SUP]
Affiliations
- PMID: 38696477
- DOI: 10.1371/journal.pone.0299390
Objective: 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.
Methods: 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.
Results: 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.
Conclusion: 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.