Yu (2020)
Multicenter cohort study demonstrates more consolidation in upper lungs on initial CT increases the risk of adverse clinical outcome in COVID-19 patients
10.7150/thno.46465
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7196305/
Findings
Radiological finding on admission (1% increase of total lesion volume vs. Not applicable)
COVID-19 (severe/critical)
Odds ratio: 0.750 (0.500-1.130) Adjusted model

China

Retrospective cohort study

Medical records

421

Enrolled 625 patients with laboratory-confirmed COVID-19 from 24 designated hospitals in Jiangsu province between 10th January and 18th February 2020. Excluded 179 patients without initial CT scans or clinical records at admission and 25 patients aged < 18 years. Consequently, included 421 patients in the final analysis.

The median age was 48.0 years (IQR 34.0-58.0) and the male proportion was 53% (224/421). Fever was the most common symptom on admission (70% [294/421]), followed by coughing. Moreover, 89 (21%) patients had comorbidities on admission with hypertension being the most common (17% [70/421]). Upon hospital admission, epidemiological, clinical, and laboratory data were collected with the median time from admission to the initial CT scan being 0 days (IQR: 2 days). The median time from illness onset to hospital admission was 5 days (IQR: 6 days) with no statistical difference between patients with or without clinical outcome. The median time from admission to a primary composite endpoint was 2 days (IQR: 0 days; range: 2-11 days). Until 6th March 2020, there were no deaths and 350 (83%) patients were discharged. During the 14-day follow-up period, 64/421 (15%) patients reached a primary composite endpoint.

Total

14 Day


COVID-19 (severe/critical)

64

64/421 (15%) patients had a composite endpoint. The composite endpoints were admission to ICU, acute respiratory failure occurrence, or shock during hospitalization.


Findings

Radiological finding on admission

Total lesion percent (%)

Not applicable

1% increase of total lesion volume


Odds ratio

0.750 (0.500-1.130)

No

No

Yes

Age, CT parameters associated with the composite endpoints - volume of the lesion, density of the lesion, and location of lesions including ground-glass opacity (GGO) and consolidation.


none

Average

Yes