Atypical chest CT scan findings have higher mortality and ICU admission among older adults with COVID-19

Abstract

Abstract Introduction : The global impact of the coronavirus pandemic has been particularly devastating among vulnerable populations, with a notably higher mortality rate observed among older adults. During this health crisis, chest computed tomography (CT) scans have emerged as a crucial diagnostic tool for identifying and assessing the severity of coronavirus disease (COVID-19). This study explored the significance of chest CT scan findings in predicting mortality and admission to the Intensive Care Unit (ICU) among older patients affected by COVID-19. Materials and Methods Conducted as a cross-sectional investigation, this study analyzed demographic characteristics such as age and gender, severity indicators (ICU admission, hospitalization outside the ICU) and outcomes (death or recovery) in a cohort of 411 COVID-19 patients aged 60 and above. Chest CT scan findings, categorized as normal, indeterminate, or abnormal, were scrutinized using SPSS ver. 24 software, with outcome analyses conducted through Chi-Square tests. Results Among the enrolled older patients, 52.3% were female, and 47.7% were male, with a mean age of 73.5 ± 8.75 years. The mortality rate reached 24.8%, and the ICU admission rate was 19%. Notably, 76.1% of subjects exhibited typical chest CT scan findings indicative of COVID-19, while 15.6% were classified as indeterminate and 8.3% as atypical. Mortality rates were 21.4% for typical findings, 28.1% for indeterminate results, and 50% for atypical findings. Furthermore, mortality among ICU-admitted patients stood at 78.2%. The incidence of atypical CT scan findings in ICU cases was 15.4%, compared to 6.6% in non-ICU cases. Conclusion The presence of atypical chest CT scan findings emerged as a significant predictor of heightened mortality and ICU admission among older individuals affected by COVID-19. This underscores the poor prognostic value associated with atypical findings in this demographic, emphasizing the importance of considering such indicators in the clinical management of older patients with COVID-19.