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Computed Tomography-based Lung Residual Volume and Mortality of Patients With Coronavirus Disease-19 (COVID-19)

2020; Lippincott Williams & Wilkins; Volume: 36; Issue: 2 Linguagem: Inglês

10.1097/rti.0000000000000572

1536-0237

David E. Timaran, Christian Alexander Torres-Ramírez, Leonardo Mauricio Morales-Jaramillo, Yohana Sarahi Mateo-Camacho, Édgar Tapia-Rangel, Karla Daniela Fuentes-Badillo, Ana Milena Hernández-Rojas, Valeria Morales-Domínguez, Pedro Fernando Saenz-Castillo, Lina Marcela Parra-Guerrero, Katherine Isamara Jacome-Portilla, Daniel Ernesto Obrando-Bravo, Giovanni Saul Contla-Trejo, Manuel Gerardo Falla-Trujillo, Gerardo Rafael Punzo-Alcaraz, Gustavo Adolfo Feria-Arroyo, Alberto Joshua Chávez-Sastre, Jovani Govea-Palma, Santiago Carrillo-Álvarez, Julita Orozco-Vázquez,

Long-Term Effects of COVID-19

To assess the effect of computed tomography (CT)-based residual lung volume (RLV) on mortality of patients with coronavirus disease 2019 (COVID-19).A single-center, retrospective study of a prospectively maintained database was performed. In total, 138 patients with COVID-19 were enrolled. Baseline chest CT scan was performed in all patients. CT-based automated and semi-automated lung segmentation was performed using the Alma Medical workstation to calculate normal lung volume, lung opacities volume, total lung volume, and RLV. The primary end point of the study was mortality. Univariate and multivariate analyses were performed to determine independent predictors of mortality.Overall, 84 men (61%) and 54 women (39%) with a mean age of 47.3 years (±14.3 y) were included in the study. Overall mortality rate was 21% (29 patients) at a median time of 7 days (interquartile range, 4 to 11 d). Univariate analysis demonstrated that age, hypertension, and diabetes were associated with death (P<0.01). Similarly, patients who died had lower normal lung volume and RLV than patients who survived (P<0.01). Multivariate analysis demonstrated that low RLV was the only independent predictor of death (odds ratio, 1.042; 95% confidence interval, 10.2-10.65). Furthermore, receiver operating characteristic curve analysis demonstrated that a RLV ≤64% significantly increased the risk of death (odds ratio, 4.8; 95% confidence interval, 1.9-11.7).Overall mortality of patients with COVID-19 may reach 21%. Univariate and multivariate analyses demonstrated that reduced RLV was the principal independent predictor of death. Furthermore, RLV ≤64% is associated with a 4-fold increase on the risk of death.