Association of severe COVID-19 outcomes with radiological scoring and cardiomegaly: findings from the COVID-19 inpatients database, Japan
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Published:2022-07-26
Issue:11
Volume:40
Page:1138-1147
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ISSN:1867-1071
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Container-title:Japanese Journal of Radiology
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language:en
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Short-container-title:Jpn J Radiol
Author:
Kanayama Atsuhiro, Tsuchihashi YuukiORCID, Otomi Yoichi, Enomoto Hideaki, Arima Yuzo, Takahashi Takuri, Kobayashi Yusuke, Kaku Koki, Sunagawa Tomimasa, Suzuki Motoi, Ajishi Yusuke, Ishii Hiroshi, Ishikawa Satoru, Iwagoe Hajime, Kaneko Yasushi, Kasahara Kei, Kawaguchi Yoji, Masuda Masafumi, Mawatari Momoko, Mishima Yasunori, Nagasaki Yoji, Ohmagari Norio, Okada Kensaku, Satoh Hiroshi, Terai Yasuhiko, Tsujie Katsuya, Watase Haruhito,
Abstract
Abstract
Purpose
We aimed to characterize novel coronavirus infections based on imaging [chest X-ray and chest computed tomography (CT)] at the time of admission.
Materials and methods
We extracted data from 396 patients with laboratory-confirmed COVID-19 who were managed at 68 hospitals in Japan from January 25 to September 2, 2020. Case patients were categorized as severe (death or treatment with invasive ventilation during hospitalization) and non-severe groups. The imaging findings of the groups were compared by calculating odds ratios (ORs) and 95% confidence intervals (95% CIs), adjusted for sex, age, and hospital size (and radiographic patient positioning for cardiomegaly). Chest X-ray and CT scores ranged from 0 to 72 and 0 to 20, respectively. Optimal cut-off values for these scores were determined by a receiver-operating characteristic (ROC) curve analysis.
Results
The median age of the 396 patients was 48 years (interquartile range 28–65) and 211 (53.3%) patients were male. Thirty-two severe cases were compared to 364 non-severe cases. At the time of admission, abnormal lesions on chest X-ray and CT were mainly observed in the lower zone/lobe. Among severe cases, abnormal lesions were also seen in the upper zone/lobe. After adjustment, the total chest X-ray and CT score values showed a dose-dependent association with severe disease. For chest X-ray scores, the area under the ROC curve (AUC) was 0.91 (95% CI = 0.86–0.97) and an optimal cut-off value of 9 points predicted severe disease with 83.3% sensitivity and 84.7% specificity. For chest CT scores, the AUC was 0.94 (95% CI = 0.89–0.98) and an optimal cut-off value of 11 points predicted severe disease with 90.9% sensitivity and 82.2% specificity. Cardiomegaly was strongly associated with severe disease [adjusted OR = 24.6 (95% CI = 3.7–166.0)].
Conclusion
Chest CT and X-ray scores and the identification of cardiomegaly could be useful for classifying severe COVID-19 on admission.
Funder
Ministry of Health, Labour and Welfare
Publisher
Springer Science and Business Media LLC
Subject
Radiology, Nuclear Medicine and imaging
Reference20 articles.
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