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 (1mm increase in distance from lesion to pleurae in lower lung vs. Not applicable)
COVID-19 (severe/critical)
Odds ratio: 0.910 (0.830-1.000) 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

(mm)

Not applicable

1mm increase in distance from lesion to pleurae in lower lung


Odds ratio

0.910 (0.830-1.000)

Yes

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