Prognostic factors of worse outcome for hospitalized COVID-19 patients, with emphasis on chest computed tomography data: a retrospective study.

Autor: do Amaral E Castro A; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil., Yokoo P; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil., Fonseca EKUN; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil., Otoni JC; Hospital Israelita Albert Einstein, Goiânia, GO, Brazil., Haiek SL; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil., Shoji H; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil., Chate RC; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil., Pereira AZ; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil., Queiroz MRG; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil., Batista MC; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil., Szarf G; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Jazyk: angličtina
Zdroj: Einstein (Sao Paulo, Brazil) [Einstein (Sao Paulo)] 2022 May 30; Vol. 20, pp. eAO6953. Date of Electronic Publication: 2022 May 30 (Print Publication: 2022).
DOI: 10.31744/einstein_journal/2022AO6953
Abstrakt: Objective: To evaluate anthropometric and clinical data, muscle mass, subcutaneous fat, spine bone mineral density, extent of acute pulmonary disease related to COVID-19, quantification of pulmonary emphysema, coronary calcium, and hepatic steatosis using chest computed tomography of hospitalized patients with confirmed diagnosis of COVID-19 pneumonia and verify its association with disease severity.
Methods: A total of 123 adults hospitalized due to COVID-19 pneumonia were enrolled in the present study, which evaluated the anthropometric, clinical and chest computed tomography data (pectoral and paravertebral muscle area and density, subcutaneous fat, thoracic vertebral bodies density, degree of pulmonary involvement by disease, coronary calcium quantification, liver attenuation measurement) and their association with poorer prognosis characterized through a combined outcome of intubation and mechanical ventilation, need of intensive care unit, and death.
Results: Age (p=0.013), body mass index (p=0.009), lymphopenia (p=0.034), and degree of pulmonary involvement of COVID-19 pneumonia (p<0.001) were associated with poor prognosis. Extent of pulmonary involvement by COVID-19 pneumonia had an odds ratio of 1,329 for a poor prognosis and a cutoff value of 6.5 for increased risk, with a sensitivity of 64.9% and specificity of 67.1%.
Conclusion: The present study found an association of high body mass index, older age, extent of pulmonary involvement by COVID-19, and lymphopenia with severity of COVID-19 pneumonia in hospitalized patients.
Databáze: MEDLINE
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