Leonardo M. Morales-Jaramillo, Department of Radiology, Centro Médico Nacional 20 de Noviembre, Mexico City, Mexico
David Timaran-Montenegro, Department of Radiology, Centro Médico Nacional 20 de Noviembre, Mexico City, Mexico
Yohana Mateo-Camacho, Department of Radiology, Centro Médico Nacional 20 de Noviembre, Mexico City, Mexico
Christian Torres-Ramírez, Department of Radiology, Centro Médico Nacional 20 de Noviembre, Mexico City, Mexico
Karla Fuentes-Badillo, Department of Radiology, Centro Médico Nacional 20 de Noviembre, Mexico City, Mexico
Valeria Morales-Domínguez, Department of Radiology, Centro Médico Nacional 20 de Noviembre, Mexico City, Mexico
Gerardo Punzo-Alcaraz,, Department of Radiology, Centro Médico Nacional 20 de Noviembre, Mexico City, Mexico
Edgar Tapia-Rangel, Department of Radiology, Centro Médico Nacional 20 de Noviembre, Mexico City, Mexico
Gustavo Feria-Arroyo, Department of Radiology, Centro Médico Nacional 20 de Noviembre, Mexico City, Mexico
Lina Parra-Guerrero, Department of Radiology, Centro Médico Nacional 20 de Noviembre, Mexico City, Mexico
Pedro Sáenz-Castillo, Department of Radiology, Centro Médico Nacional 20 de Noviembre, Mexico City, Mexico
Ana Hernández-Rojas, Department of Radiology, Centro Médico Nacional 20 de Noviembre, Mexico City, Mexico
Manuel Falla-Trujillo, Department of Radiology, Centro Médico Nacional 20 de Noviembre, Mexico City, Mexico
Daniel Obando-Bravo, Department of Radiology, Centro Médico Nacional 20 de Noviembre, Mexico City, Mexico
Giovanni Contla-Trejo, Department of Radiology, Centro Médico Nacional 20 de Noviembre, Mexico City, Mexico
Katherine Jácome-Portilla, Department of Radiology, Centro Médico Nacional 20 de Noviembre, Mexico City, Mexico
Alberto Chávez-Sastré, Department of Radiology, Centro Médico Nacional 20 de Noviembre, Mexico City, Mexico
Jovani Govea-Palma, Department of Radiology, Centro Médico Nacional 20 de Noviembre, Mexico City, Mexico
Santiago Carrillo-Álvarez, Department of Radiology, Centro Médico Nacional 20 de Noviembre, Mexico City, Mexico
Julita Orozco-Vázquez, Department of Radiology, Centro Médico Nacional 20 de Noviembre, Mexico City, Mexico
Dulce Bonifacio-Delgadillo, Department of Radiology, Centro Médico Nacional 20 de Noviembre, Mexico City, Mexico
Objective: To assess the association between CT-based percentage of pathological lung opacities volume (%PLOV) and the occurrence of adverse outcomes of patients with COVID-19. Methods: An observational, longitudinal, single-center study was performed including patients with COVID-19. CT-based lung segmentation was performed to calculate %PLOV. The primary endpoint was the occurrence of adverse lung event (ALE), defined as ICU admission, the use of mechanical ventilation, or death. Mann-Whitney U test was performed for univariate analysis. Logistic regression analysis was performed to determine independent predictors of critical illness. Results: 138 patients (84 men [61%]) with a mean age of 47.3 years were enrolled. Median %PLOV was 28.64% (interquartile range [IQR], 6.33-47.22%). ALE occurred in 52 patients (38%) with an overall mortality rate of 21% (29 patients). Multivariate analysis demonstrated that %PLOV was an independent predictor of ALE with an Odds ratio of 1.049 (95% confidence interval [CI], 1.014-1.085) (p < 0.01). Furthermore, a %PLOV of 64% demonstrated a 25.5-fold increased risk of ALE with a sensitivity and specificity higher than 75% (p < 0.01). Conclusion: The quantitative evaluation of chest CT impacts the determination of severity of COVID-19 pneumonia on admission. %PLOV was the strongest predictor for the development of ALE in hospitalized patients.
Keywords: CT volumetry. COVID 19. Coronavirus. Adverse outcomes.