Colombi (2020)
Well-aerated Lung on Admitting Chest CT to Predict Adverse Outcome in COVID-19 Pneumonia
Laboratory Findings
CRP (Abnormal vs. Normal)
COVID-19 (severe/fatal)
Odds ratio: 2.200 (1.100-4.400) Adjusted model


Retrospective observational study

Medical records


Consecutive patients with suspected COVID-19 interstitial pneumonia who underwent chest CT at emergency department admission between February 17 to March 10, 2020.

The study included 236 patients (median age, 68 years old; 95%CI, 66-70 years old), 59/236 (25%, 95%CI: 19% to 31%) were females. All the patients performed reversetranscription polymerase chain reaction (RT-PCR) for SARS-CoV-2 in nasal-pharyngeal swabs. However, a rapid (minutes to hours) COVID-19 RT-PCR test result was not available at our center during this interval. Therefore, chest CT was performed based on high clinical suspicion in addition to clinical and laboratory findings consistent with COVID-19 in the setting of high pre-test probability (i.e., high community disease burden) of COVID-19


COVID-19 (severe/fatal)


Patients were admitted to the ICU or who died (ICU/death) versus those patients who were discharged from the hospital alive without ICU admission. The time between CT and ICU admission or death was also registered. Visual and software-based quantification of well aerated lung parenchyma on admission chest CT were predictors of intensive care unit (ICU) admission or death in patients with COVID-19 pneumonia.

Laboratory Findings


C-reactive protein (CRP, 7.6 mg/dl; 95% CI, 6.4 to 8.6 mg/dl)



Odds ratio

2.200 (1.100-4.400)




Age, comorbidities - Cardiovascular diseases, SpO2, platelet, C-reactive protein and well-aerated lung parenchyma absolute volume, eGFR, LDH, adipose tissue area measured at T7-T8 level.

Both visual and software-based quantification of the well aerated lung on chest CT obtained in the emergency setting were independent predictors of ICU admission or death in patients with COVID-19. Quantitative assessment of the extent of lung involvement by COVID-19 pneumonia may be useful for routine patient management. Age group modified by curator for pooled analysis.