Published in:
01-12-2020 | Coronavirus | Original Article
COVID-19 pneumonia in the emergency department: correlation of initial chest CT findings with short-term outcome
Authors:
Camila Silva Barbosa, Guilherme Wilson Otaviano Garcia Chaves, Camila Vilela de Oliveira, Guilherme Hipolito Bachion, Chang Kai Chi, Giovanni Guido Cerri, Thais Carneiro Lima, Hye Ju Lee
Published in:
Emergency Radiology
|
Issue 6/2020
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Abstract
Purpose
Evaluate chest computed tomography (CT) findings of laboratory-confirmed Coronavirus Disease 2019 (COVID-19) cases and correlate it with clinical and laboratorial signs of severe disease and short-term outcome.
Methods
Chest CTs of 61 consecutive cases of COVID-19 disease that attended in our emergency department (ED) were reviewed. Three groups of patients classified according to the short-term follow-up were compared: (1) early-discharged from ED, (2) hospitalized on regular wards, and (3) admitted to intensive care unit (ICU). CT findings were also correlated with clinical and laboratorial features associated with severe disease.
Results
Median age was 52 years (IQR 39–63) with male predominance (60.7%). Most of the patients that did not require hospitalization had parenchymal involvement of less than 25% on CT (84.6%). Among hospitalized patients, interlobular septal thickening and extensive lung disease (> 50% of parenchyma) were significantly more frequent in ICU-admitted patients (P = 0.018 and P = 0.043, respectively). Interlobular septal thickening also correlated with longer ICU stay (P = 0.018). Low oxygen saturation (SpO2 ≤ 93%) was associated with septal thickening (P = 0.004), diffuse distribution (P = 0.016), and pleural effusion (P = 0.037) on CT. All patients with > 50% of parenchymal involvement showed SpO2 ≤ 93%. Elevated C-reactive protein (CRP) levels (> 5.0 mg/dL) correlated with consolidation (P = 0.002), septal thickening (P = 0.018), diffuse distribution (P = 0.020), and more extensive parenchymal involvement (P = 0.017).
Conclusion
Interlobular septal thickening on CT was associated with ICU admission and longer stay on ICU. Diffuse distribution, septal thickening, and more extensive lung involvement correlated with lower SpO2 and higher CRP levels. Patients that needed hospitalization and ICU admission presented more extensive lung disease on CT.