Background The relationship between computed tomography (CT) and prognosis of patients with COVID-19 pneumonia remains unclear. We hypothesized that the Ichikado CT score, obtained in the first 24 h of hospital admission, is an independent predictor for all-cause mortality during hospitalization in patients with COVID-19 pneumonia. Methods Single-center retrospective cohort study of patients with confirmed COVID-19 pneumonia admitted at our institution between March 20th, 2020 and October 31st, 2020. Patients were enrolled if, within 24 h of admission, a chest CT scan, an arterial blood gas, a complete blood count, and a basic metabolic panel were performed. Two independent radiologists, who were blinded to clinical data, retrospectively evaluated the chest CT scans following a previously described qualitative and quantitative CT scoring system. The primary outcome was all-cause in-hospital mortality or survival to hospital discharge. Secondary outcomes were new requirements for invasive mechanical ventilation and hospital length of stay. Cox regression models were used to test the association between potential independent predictors and all-cause mortality. Results Two hundred thirty-five patients, 197 survivors and 38 nonsurvivors, were studied. The median Ichikado CT score for nonsurvivors was significantly higher than survivors ( P < 0.001). An Ichikado CT score of more than 172 enabled prediction of mortality, with a sensitivity of 84.2% and a specificity of 79.7%. Multivariate analysis identified Ichikado CT score (HR, 7.772; 95% CI, 3.164–19.095; P < 0.001), together with age (HR, 1.030; 95% CI, 1.030–1.060; P = 0.043), as independent predictors of all-cause in-hospital mortality. Conclusions Ichikado CT score is an independent predictor of both requiring invasive mechanical ventilation and all-cause mortality in patients hospitalized with COVID-19 pneumonia. Further prospective evaluation is necessary to confirm these findings. Trial registration: The WCG institutional review board approved this retrospective study and patient consent was waived due to its non-interventional nature (Identifier: 20210799).
【저자키워드】 COVID-19, Coronavirus disease 2019, tomography, CT score, Ichikado CT score, COVID-19 prognostic factor, 【초록키워드】 Mortality, Hospitalization, Pneumonia, hospital, outcome, Computed tomography, Retrospective study, sensitivity, specificity, survival, complete blood count, Patient, age, Hospital admission, Quantitative, Admission, patients, in-hospital mortality, Blood, association, Multivariate analysis, Invasive mechanical ventilation, chest CT scan, scoring system, Cox regression model, retrospective cohort study, Radiologists, Primary outcome, 95% CI, Clinical data, nonsurvivors, all-cause mortality, hospital discharge, survivor, secondary, independent, Result, enrolled, described, performed, evaluated, approved, median, were used, significantly higher, prognosis of patient, independent predictor, nonsurvivor, patients hospitalized, patients with COVID-19, were blinded, with COVID-19, 【제목키워드】 coronavirus disease, prognostic, retrospective cohort study,