Open AccessThe role of a chest computed tomography severity score in coronavirus disease 2019 pneumonia
Author(s) -
Fausto Salaffi,
Marina Carotti,
Marika Tardella,
Alessandra Borgheresi,
Andrea Agostini,
Davide Minorati,
Daniela Marotto,
Marco Di Carlo,
Massimo Galli,
Andrea Giovagi,
Piercarlo SarziPuttini
Publication year - 2020
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000022433
Subject(s) - medicine , youden's j statistic , receiver operating characteristic , severity of illness , covid-19 , computed tomography , radiology , pneumonia , grading (engineering) , area under the curve , disease , infectious disease (medical specialty) , civil engineering , engineering
The chest computed tomography (CT) characteristics of coronavirus disease 2019 (COVID-19) are important for diagnostic and prognostic purposes. The aim of this study was to investigate chest CT findings in COVID-19 patients in order to determine the optimal cut-off value of a CT severity score that can be considered a potential prognostic indicator of a severe/critical outcome. The CT findings were evaluated by means of a severity score that included the extent (0–4 grading scale) and nature (0–4 grading scale) of CT abnormalities. The images were evaluated at 3 levels bilaterally. A receiver operating characteristics (ROC) curve was used to identify the optimal score (Youden's index) predicting severe/critical COVID-19. The study involved 165 COVID-19 patients (131 men [79.4%] and 34 women [20.6%] with a mean age of 61.5 ± 12.5 years), of whom 30 (18.2%) had severe/critical disease and 135 (81.8%) mild/typical disease. The most frequent CT finding was bilateral predominantly subpleural and basilar airspace changes, with more extensive ground-glass opacities than consolidation. CT findings of consolidation, a crazy-paving pattern, linear opacities, air bronchogram, and extrapulmonary lesions correlated with severe/critical COVID-19. The mean CT severity score was 63.95 in the severe/critical group, and 35.62 in the mild/typical group ( P < .001). ROC curve analysis showed that a CT severity score of 38 predicted the development of severe/critical symptoms. A CT severity score can help the risk stratification of COVID-19 patients.