Maximum chest CT score predicts progression to severe illness in patients with COVID-19: a retrospective study from Wuhan, China
Abstract Background: We investigated the clinical course and imaging findings of hospitalized patients who were initially diagnosed with moderate COVID-19 symptoms to identify risk factors associated with progression to severe/critical symptoms.Methods: This study was a retrospective single-center study at The Central Hospital of Wuhan. 243 patients with confirmed COVID19 pneumonia were enrolled in the analysis, of which 40 patients progressed from moderate to severe/critical symptoms during follow up. Demographic, clinical, laboratory and radiological data were extracted from electronic medical records and compared between moderate and severe/critical symptom types. Univariable and multivariable logistic regressions were used to identify the risk factors associated with symptom progression.Results: Patients with severe/critical symptoms were older (p<0.001) and more often male (p=0.046). We found that the combination of chronic obstructive pulmonary disease and high maximum CT scores was associated with disease progression. Maximum CT scores (≥11) had the greatest predictive value for disease progression. The area under the receiver operating characteristic curve (ROC) was 0.861 (95% CI: 0.811-0.902).Conclusions: Maximum CT scores and COPD are associated with patient deterioration. Maximum CT scores (≥11) are associated with severe illness.