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The prognostic value of pneumonia severity score and pectoralis muscle Area on chest CT in adult COVID-19 patients

Authors
  • Ufuk, Furkan1
  • Demirci, Mahmut1
  • Sagtas, Ergin1
  • Akbudak, Ismail Hakkı2
  • Ugurlu, Erhan3
  • Sari, Tugba4
  • 1 Department of Radiology, University of Pamukkale, Kinikli, 20100 Denizli, Turkey
  • 2 Department of Internal Medicine, University of Pamukkale, Kinikli, 20100 Denizli, Turkey
  • 3 Department of Chest Diseases, University of Pamukkale, Kinikli, 20100 Denizli, Turkey
  • 4 Department of Infectious Diseases, University of Pamukkale, Kinikli, 20100 Denizli, Turkey
Type
Published Article
Journal
European Journal of Radiology
Publisher
Elsevier B.V.
Publication Date
Sep 09, 2020
Volume
131
Pages
109271–109271
Identifiers
DOI: 10.1016/j.ejrad.2020.109271
PMID: 32942198
PMCID: PMC7480333
Source
PubMed Central
Keywords
License
Unknown

Abstract

Purpose To assess the prognostic value of pneumonia severity score (PSS), pectoralis muscle area (PMA), and index (PMI) on chest computed tomography (CT) in adult coronavirus disease 2019 (COVID-19) patients. Method The chest CT images of COVID-19 patients were evaluated for the PSS as the ratio of the volume of involved lung parenchyma to the total lung volume. The cross-sectional areas of the pectoralis muscles (PMA, cm2) were also measured automatically on axial CT images, and PMI was calculated as the following formula: PMI = PMA / patient’s height square (m2). The relationship between clinical variables, PSS, PMA, sex-specific PMI values, and patient outcomes (intubation, prolonged hospital stay, and death) were investigated using multivariable logistic regression analysis. All patients were followed for more than a month. Results One-hundred thirty patients (76 males, 58.46 %) were included in the study. Fifteen patients (11.54 %) were intubated, 24 patients (18.46 %) had prolonged hospital stay, and eight patients (6.15 %) died during follow-up. Patients with comorbidity had a higher mean of PSS (6.3 + 4.5 vs 3.9 + 3.8; p = 0.001). After adjusting the confounders, PSS was an independent predictor of intubation (adjusted Odds Ratio [OR]: 1.73, 95 % CI 1.31−2.28, p < 0.001), prolonged hospital stay (OR: 1.20, 95 % CI 1.09−1.33, p < 0.001), and death (OR: 2.13, 95 % CI 1.1−4.13, p = 0.026. PMI value was a predictor of prolonged hospital stay (OR: 0.83, 95 % CI 0.72−0.96, p = 0.038) and death (OR: 0.53, 95 % CI 0.29−0.96, p = 0.036). Incrementally increasing PMA value was a predictor of prolonged hospital stay (OR: 0.93, 95 % CI 0.89−0.98, p = 0.01) and intubation (OR: 0.98, 95 % CI 0.96−1, p = 0.036). Conclusion PSS, PMA, and PMI values have prognostic value in adult COVID-19 patients and can be easily assessed on chest CT images.

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