Computed Tomography-based determinants for predicting death and ICU requirement in patients suffering COVID-19
Abstract Background: What has received special attention in recent months is the use of a combination of clinical findings, laboratory markers, and, in addition, the findings of lung Computed Tomography (CT) scan in the design and delivery of risk scoring systems for Coronavirus Disease 2019 (COVID -19) patients. The present study aimed to determine main lung CT-related correlates of disease severity (Intensive Care Units (ICU) requiring) as well as death in COVID -19 patients.Methods: This cross-sectional study was performed on 515 consecutive patients with definitive diagnosis of COVID-19 admitted to one of the COVID -19 referral hospitals in Tehran. All patients' information was collected through a review of their archives. All patients were evaluated by CT scan of the lungs.Results: The mean follow-up of patients from the time of admission was 10.85±6.11 days between 1 and 30 days. During this period, a total of 29.1% were admitted to the ICU. Also, the mortality rate of patients was equal to 28.2%. According to multivariable logistic regression model with the presence of death-related correlates, crazy paving pattern, diffuse distribution of lesions, CT Severity Score (CTSS) score >12, the presence of plural effusion or emphysema were the main determinants of COVID -19 related death and should be considered for presenting new scoring system for predicting death following COVID -19 disease. In similar model, CTSS score >12 along with the presence of plural effusion, emphysema, or pulmonary hypertension were the main determinants of requiring ICU admission. Conclusion: The CT score higher than 12 along with observing the pattern of diffuse distribution of lesions especially accompanied with emphysema, pleural effusion or pulmonary hypertension can predict patient mortality or will determine the need for hospitalization in the ICU.