Rationale: To identify whether the initial chest computed tomography (CT) findings of patients with coronavirus disease 2019 (COVID-19) are helpful for predicting the clinical outcome. Methods: A total of 224 patients with laboratory-confirmed COVID-19 who underwent chest CT examination within the first day of admission were enrolled. CT findings, including the pattern and distribution of opacities, the number of lung lobes involved and the chest CT scores of lung involvement, were assessed. Independent predictors of adverse clinical outcomes were determined by multivariate regression analysis. Adverse outcome were defined as the need for mechanical ventilation or death. Results: Of 224 patients, 74 (33%) had adverse outcomes and 150 (67%) had good outcomes. There were higher frequencies of more than four lung zones involved (73% vs 32%), both central and peripheral distribution (57% vs 42%), consolidation (27% vs 17%), and air bronchogram (24% vs 13%) and higher initial chest CT scores (8.6±3.4 vs 5.4±2.1) ( P < 0.05 for all) in the patients with poor outcomes. Multivariate analysis demonstrated that more than four lung zones (odds ratio [OR] 3.93; 95% confidence interval [CI]: 1.44 to 12.89), age above 65 (OR 3.65; 95% CI: 1.11 to 10.59), the presence of comorbidity (OR 5.21; 95% CI: 1.64 to 19.22) and dyspnea on admission (OR 3.19; 95% CI: 1.35 to 8.46) were independent predictors of poor outcome. Conclusions: Involvement of more than four lung zones and a higher CT score on the initial chest CT were significantly associated with adverse clinical outcome. Initial chest CT findings may be helpful for predicting clinical outcome in patients with COVID-19.
【저자키워드】 COVID-19, SARS-CoV-2, CT, clinical outcomes, 【초록키워드】 coronavirus disease, Coronavirus disease 2019, mechanical ventilation, lung involvement, lung, Comorbidity, outcome, adverse outcomes, Clinical outcome, adverse outcome, outcomes, Computed tomography, Chest computed tomography, Chest CT, Dyspnea, Patient, death, age, predictor, pattern, distribution, Admission, consolidation, multivariate regression analysis, patients, Multivariate analysis, Frequency, Odds ratio, independent predictors, on admission, determined by, air bronchogram, regression analysis, Adverse, 95% CI, chest CT examination, 95% confidence interval, Laboratory-confirmed COVID-19, rationale, CT findings, bronchogram, zone, laboratory-confirmed, initial, lung lobes, enrolled, defined, identify, significantly, involved, the patient, demonstrated, Involvement, independent predictor, lung lobe, patients with COVID-19, were assessed, 【제목키워드】 Chest CT, initial, patients with COVID-19,