Computed tomography findings of COVID-19 pneumonia in Intensive Care Unit-patients.
Computed tomography findings of COVID-19 pneumonia in Intensive Care Unit-patients.
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DOI：
10.4081/jphr.2021.2270
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发表时间：
2021-04-19
影响因子：
2.3
通讯作者：
Saba L
中科院分区：
文献类型：
--
作者：
Cau R;Falaschi Z;Paschè A;Danna P;Arioli R;Arru CD;Zagaria D;Tricca S;Suri JS;Karla MK;Carriero A;Saba L
背景资料：2019年12月，中国武汉发生了一系列不明原因肺炎病例，导致将责任病原体确定为SARS-coV-2。从那时起，2019冠状病毒病（COVID-19）已蔓延到整个世界。计算机断层扫描（CT）经常用于评估COVID-19肺炎的严重程度和并发症。本研究的目的是比较重症监护病房（ICU）和非ICU COVID-19肺炎患者的CT模式和临床特征。设计和方法：这项回顾性研究纳入了218例实验室确诊的SARS-coV-2连续患者（136例男性; 82例女性;平均年龄63 ± 15岁）。患者分为两组：（a）ICU患者和（B）非ICU住院患者。我们通过胸部CT检查评估肺部阴影的类型和程度，并记录所有患者的合并症和实验室检查值。结果如下：在218例患者中，23例（20例男性：3例女性;平均年龄60岁）需要入住ICU，195例（118例男性：77例女性，平均年龄64岁）入住临床病房。与非ICU患者相比，ICU患者主要为男性（60% vs 83%，p = 0.03），合并症较多，CRP阳性（p = 0.04），LDH值较高（p = 0.008）。ICU患者的胸部CT显示实变（p = 0.03）、混合性病变（p = 0.01）、双侧阴影（p <0.01）的发生率较高，实变（p = 0.02）和GGO（p = 0.001）的肺受累总体更大。结论：受COVID-19影响的ICU患者的CT影像学特征与非ICU患者相比有显著差异。CT特征的识别有助于疾病严重程度的分层和支持性治疗。 我们研究的主要意义是ICU和非ICU环境中COVID-19患者的CT和实验室检查结果的差异。虽然这些发现的前瞻性影响尚未评估，但认识到这些发现可能有助于医生预测疾病进程并将患者分诊到早期ICU管理。我们的研究强调了结构化和定量报告格式的重要性，放射科医生明确描述了肺部阴影的具体模式（如GGO，实变和混合）以及涉及COVID-19肺炎的肺部面积和肺叶数量。到
Background: In December 2019, a cluster of unknown etiology pneumonia cases occurred in Wuhan, China leading to identification of the responsible pathogen as SARS-coV-2. Since then, the coronavirus disease 2019 (COVID-19) has spread to the entire world. Computed Tomography (CT) is frequently used to assess severity and complications of COVID-19 pneumonia. The purpose of this study is to compare the CT patterns and clinical characteristics in intensive care unit (ICU) and non- ICU patients with COVID-19 pneumonia. Design and Methods: This retrospective study included 218 consecutive patients (136 males; 82 females; mean age 63±15 years) with laboratory-confirmed SARS-coV-2. Patients were categorized in two different groups: (a) ICU patients and (b) non-ICU inpatients. We assessed the type and extent of pulmonary opacities on chest CT exams and recorded the information on comorbidities and laboratory values for all patients. Results: Of the 218 patients, 23 (20 males: 3 females; mean age 60 years) required ICU admission, 195 (118 males: 77 females, mean age 64 years) were admitted to a clinical ward. Compared with non-ICU patients, ICU patients were predominantly males (60% versus 83% p=0.03), had more comorbidities, a positive CRP (p=0.04) and higher LDH values (p=0.008). ICU patients’ chest CT demonstrated higher incidence of consolidation (p=0.03), mixed lesions (p=0.01), bilateral opacities (p<0.01) and overall greater lung involvement by consolidation (p=0.02) and GGO (p=0.001). Conclusions: CT imaging features of ICU patients affected by COVID-19 are significantly different compared with non-ICU patients. Identification of CT features could assist in a stratification of the disease severity and supportive treatment. The major implication of our study is the differences in CT and laboratory findings in COVID-19 patients in ICU and non-ICU settings. Although the prospective impact of these findings was not assessed, recognition of these findings may help physicians anticipate the disease course and triage the patient to early ICU management. Our study highlights the importance of structured and quantitative reporting format where radiologists explicitly describe the specific pattern of pulmonary opacities (such as GGO, consolidation, and mixed) as well as lung areas and the number of lung lobes involved with COVID-19 pneumonia. To