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COVID-19 pneumonia: Perfusion abnormalities shown on subtraction CT angiography in apparently well-ventilated lungs. A prospective cohort study.
Santamarina, Mario G; Lomakin, Felipe Martinez; Beddings, Ignacio; Riscal, Dominique Boisier; Chang Villacís, Jose; Contreras, Roberto; Marambio, Jaime Vidal; Labarca, Eduardo; Torres, Jorge; Volpacchio, Mariano.
Afiliação
  • Santamarina MG; Radiology Department, Hospital Naval Almirante Nef, Viña del Mar, Chile.
  • Lomakin FM; Radiology Department, Hospital Dr. Eduardo Pereira, Valparaiso, Chile.
  • Beddings I; Intensive Care Unit, Hospital Naval Almirante Nef, Viña del Mar, Chile.
  • Riscal DB; Universidad Andrés Bello, Viña del Mar, Escuela de Medicina, Facultad de Medicina Viña del Mar, Valparaiso, Chile.
  • Chang Villacís J; Radiology Department, Hospital Clínico San Borja Arriaran, Santiago, Chile.
  • Contreras R; Intensive Care Unit, Hospital Naval Almirante Nef, Viña del Mar, Chile.
  • Marambio JV; Intensive Care Unit, Hospital San Martin de Quillota, Quillota, Chile.
  • Labarca E; Intensive Care Unit, Hospital San Martin de Quillota, Quillota, Chile.
  • Torres J; Intensive Care Unit, Hospital Naval Almirante Nef, Viña del Mar, Chile.
  • Volpacchio M; Intensive Care Unit, Hospital Naval Almirante Nef, Viña del Mar, Chile.
Heliyon ; 9(7): e18085, 2023 Jul.
Article em En | MEDLINE | ID: mdl-37519667
Purpose: To evaluate whether a subtraction CT angiography (sCTA) perfusion score may have prognostic value in patients with COVID-19 pneumonia. Method: This prospective cohort study included adult patients with RT-PCR-confirmed SARS-CoV-2 infection admitted to the ED and a sCTA performed within 24 h of admission between June and September 2020. Perfusion abnormalities (PA) in areas of apparently spared lung parenchyma on conventional CT images were assessed with sCTA perfusion score. Airspace disease extension was assessed with CT severity scores, which were then correlated with clinical outcomes (admission to ICU, requirement of IMV, and death). Inter-rater reliability (IRR) was assessed using Cohen's Kappa. Independent predictors of adverse outcomes were evaluated by multivariable logistic regression analyses using the Hosmer and Lemeshow's test. Results: 191 patients were included: 112 males (58%), median age of 60.8 years (SD ± 16.0). The IRR was very high (median Kappa statistic: 0.95). No association was found between perfusion CT scores and D-dimer levels (Kendall's Tau-B coefficient = 0.08, p = 0.16) or between PaO2/FiO2 ratios and D-dimer levels (Kendall's Tau-B coefficient = -0.10, p = 0.07). Multivariate analyses adjusting for parenchymal disease extension, vascular beaded appearance, pulmonary embolism, sex, and age showed that severe PA remained a significant predictor for ICU admission (AOR: 6.25, 95% CI 2.10-18.7, p = 0.001). The overall diagnostic capacity of this model was adequate (ROC AUC: 0.83; 95% CI 0.77-0.89). Conclusions: The assessment of pulmonary perfusion abnormalities in areas of apparently spared lung parenchyma on conventional CT images via sCTA perfusion scoring has prognostic value in COVID-19 pneumonia.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Heliyon Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Chile País de publicação: Reino Unido
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Heliyon Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Chile País de publicação: Reino Unido