Computed tomography findings of COVID-19 pneumonia in Intensive Care Unit-patients

  • Riccardo Cau
    Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.) di Cagliari, Polo di Monserrato (CA), Italy.
    https://orcid.org/0000-0002-7910-1087
  • Zeno Falaschi
    Department of Radiology, A.O.U. “Maggiore d.c.”, University of Eastern Piedmont, Novara, Italy.
    https://orcid.org/0000-0003-3583-2731
  • Alessio Paschè
    Department of Radiology, A.O.U. “Maggiore d.c.”, University of Eastern Piedmont, Novara, Italy.
    https://orcid.org/0000-0001-8560-3158
  • Pietro Danna
    Department of Radiology, A.O.U. “Maggiore d.c.”, University of Eastern Piedmont, Novara, Italy.
    https://orcid.org/0000-0001-8928-7666
  • Roberto Arioli
    Department of Radiology, A.O.U. “Maggiore d.c.”, University of Eastern Piedmont, Novara, Italy.
    https://orcid.org/0000-0001-6638-8253
  • Chiara D. Arru
    Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.) di Cagliari, Polo di Monserrato (CA), Italy.
  • Domenico Zagaria
    Department of Radiology, A.O.U. “Maggiore d.c.”, University of Eastern Piedmont, Novara, Italy.
  • Stefano Tricca
    Department of Radiology, A.O.U. “Maggiore d.c.”, University of Eastern Piedmont, Novara, Italy.
    https://orcid.org/0000-0003-0555-3117
  • Jasjit S. Suri
    Stroke Monitoring and Diagnosis Division, AtheroPoint™, Roseville, CA, and Global Biomedical Technologies, Inc., Roseville, CA, United States.
    https://orcid.org/0000-0001-6499-396X
  • Mannudeep K. Karla
    Department of Radiology, Massachusetts General Hospital, Boston, MA, United States.
  • Alessandro Carriero
    Department of Radiology, A.O.U. “Maggiore d.c.”, University of Eastern Piedmont, Novara, Italy.
    https://orcid.org/0000-0001-7481-7169
  • Luca Saba
    Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.) di Cagliari, Polo di Monserrato (CA), Italy.

ABSTRACT

Background: In December 2019, a cluster of unknown etiology pneumonia cases occurred in Wuhan, China leading to identification of the responsible pathogen as SARS-coV-2. Since then, the coronavirus disease 2019 (COVID-19) has spread to the entire world. Computed Tomography (CT) is frequently used to assess severity and complications of COVID-19 pneumonia. The purpose of this study is to compare the CT patterns and clinical characteristics in intensive care unit (ICU) and non-ICU patients with COVID-19 pneumonia.

Design and Methods:
 This retrospective study included 218 consecutive patients (136 males; 82 females; mean age 63±15 years) with laboratory-confirmed SARS-coV-2. Patients were categorized in two different groups: (a) ICU patients and (b) non-ICU inpatients. We assessed the type and extent of pulmonary opacities on chest CT exams and recorded the information on comorbidities and laboratory values for all patients.

Results:
 Of the 218 patients, 23 (20 males: 3 females; mean age 60 years) required ICU admission, 195 (118 males: 77 females, mean age 64 years) were admitted to a clinical ward. Compared with non-ICU patients, ICU patients were predominantly males (60% versus 83% p=0.03), had more comorbidities, a positive CRP (p=0.04) and higher LDH values (p=0.008). ICU patients’ chest CT demonstrated higher incidence of consolidation (p=0.03), mixed lesions (p=0.01), bilateral opacities (p<0.01) and overall greater lung involvement by consolidation (p=0.02) and GGO (p=0.001).

Conclusions
: CT imaging features of ICU patients affected by COVID-19 are significantly different compared with non-ICU patients. Identification of CT features could assist in a stratification of the disease severity and supportive treatment.

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