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Impact of Computed Tomography-Quantified Emphysema Score on Clinical Outcome in Patients with COVID-19.
Int J Gen Med. 2021; 14:3327-3333.IJ

Abstract

Background

Chronic obstructive pulmonary disease (COPD) is considered a risk factor for poor outcomes in patients with coronavirus disease 2019 (COVID-19). However, data on the prognostic impact of radiological emphysema extent on patients with COVID-19 are limited. Thus, this study aimed to examine whether computed tomography (CT)-quantified emphysema score is associated with a worse clinical outcome in patients with COVID-19.

Methods

Volumetric quantitative analyses of CT images were performed to obtain emphysema scores in COVID-19 patients admitted to four tertiary referral hospitals in Daegu, South Korea, between February 18 and March 25, 2020. Patients were divided into three groups according to emphysema score (emphysema score ≤1%, 1%< emphysema score ≤5%, and emphysema score >5%).

Results

A total of 146 patients with confirmed SARS-CoV-2 infection were included. The median emphysema score was 1.0% (interquartile range, 0.5-1.8%). Eight patients (6%) had a previous COPD diagnosis. Eighty (55%), 55 (38%), and 11 (8%) patients had emphysema scores ≤1%, between 1% and 5%, and >5%, respectively. The number of patients who received oxygen therapy two weeks after admission was significantly higher in the group with emphysema scores >5% than in other groups (p=0.025). The frequency of deaths was three (27%) in the group with emphysema scores >5% and tended to be higher than that in other groups. Multivariate analysis revealed that age, COPD, and serum lactate dehydrogenase levels were associated with a greater risk of in-hospital mortality in patients with COVID-19.

Conclusion

The current study demonstrated that patients with CT-quantified emphysema scores >5% tended to progress to severe disease over time; however, they did not exhibit an increased risk of mortality in our COVID-19 cohort. Further studies with consideration of both emphysema extent and airflow limitation degree are warranted.

Authors+Show Affiliations

Department of Radiology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.Department of Radiology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.Department of Radiology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Republic of Korea.Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Republic of Korea.Department of Radiology, Daegu Catholic University School of Medicine, Daegu, Republic of Korea.Department of Radiology, Dongsan Hospital, Keimyung University School of Medicine, Daegu, Republic of Korea.Department of Radiology, College of Medicine, Yeungnam University, Daegu, Republic of Korea.Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

34285557

Citation

Lim, Jae-Kwang, et al. "Impact of Computed Tomography-Quantified Emphysema Score On Clinical Outcome in Patients With COVID-19." International Journal of General Medicine, vol. 14, 2021, pp. 3327-3333.
Lim JK, Park B, Park J, et al. Impact of Computed Tomography-Quantified Emphysema Score on Clinical Outcome in Patients with COVID-19. Int J Gen Med. 2021;14:3327-3333.
Lim, J. K., Park, B., Park, J., Choi, K. J., Jung, C. Y., Kim, Y. H., Kim, J. Y., Moon, S., Lee, Y. H., & Lee, J. (2021). Impact of Computed Tomography-Quantified Emphysema Score on Clinical Outcome in Patients with COVID-19. International Journal of General Medicine, 14, 3327-3333. https://doi.org/10.2147/IJGM.S317295
Lim JK, et al. Impact of Computed Tomography-Quantified Emphysema Score On Clinical Outcome in Patients With COVID-19. Int J Gen Med. 2021;14:3327-3333. PubMed PMID: 34285557.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of Computed Tomography-Quantified Emphysema Score on Clinical Outcome in Patients with COVID-19. AU - Lim,Jae-Kwang, AU - Park,Byunggeon, AU - Park,Jongmin, AU - Choi,Keum-Ju, AU - Jung,Chi-Young, AU - Kim,Young Hwan, AU - Kim,Jin Young, AU - Moon,Sungjun, AU - Lee,Yong Hoon, AU - Lee,Jaehee, Y1 - 2021/07/12/ PY - 2021/04/24/received PY - 2021/06/28/accepted PY - 2021/7/21/entrez PY - 2021/7/22/pubmed PY - 2021/7/22/medline KW - COPD KW - COVID-19 KW - computed tomography KW - emphysema KW - mortality SP - 3327 EP - 3333 JF - International journal of general medicine JO - Int J Gen Med VL - 14 N2 - Background: Chronic obstructive pulmonary disease (COPD) is considered a risk factor for poor outcomes in patients with coronavirus disease 2019 (COVID-19). However, data on the prognostic impact of radiological emphysema extent on patients with COVID-19 are limited. Thus, this study aimed to examine whether computed tomography (CT)-quantified emphysema score is associated with a worse clinical outcome in patients with COVID-19. Methods: Volumetric quantitative analyses of CT images were performed to obtain emphysema scores in COVID-19 patients admitted to four tertiary referral hospitals in Daegu, South Korea, between February 18 and March 25, 2020. Patients were divided into three groups according to emphysema score (emphysema score ≤1%, 1%< emphysema score ≤5%, and emphysema score >5%). Results: A total of 146 patients with confirmed SARS-CoV-2 infection were included. The median emphysema score was 1.0% (interquartile range, 0.5-1.8%). Eight patients (6%) had a previous COPD diagnosis. Eighty (55%), 55 (38%), and 11 (8%) patients had emphysema scores ≤1%, between 1% and 5%, and >5%, respectively. The number of patients who received oxygen therapy two weeks after admission was significantly higher in the group with emphysema scores >5% than in other groups (p=0.025). The frequency of deaths was three (27%) in the group with emphysema scores >5% and tended to be higher than that in other groups. Multivariate analysis revealed that age, COPD, and serum lactate dehydrogenase levels were associated with a greater risk of in-hospital mortality in patients with COVID-19. Conclusion: The current study demonstrated that patients with CT-quantified emphysema scores >5% tended to progress to severe disease over time; however, they did not exhibit an increased risk of mortality in our COVID-19 cohort. Further studies with consideration of both emphysema extent and airflow limitation degree are warranted. SN - 1178-7074 UR - https://www.unboundmedicine.com/medline/citation/34285557/Impact_of_Computed_Tomography-Quantified_Emphysema_Score_on_Clinical_Outcome_in_Patients_with_COVID-19. L2 - https://dx.doi.org/10.2147/IJGM.S317295 DB - PRIME DP - Unbound Medicine ER -
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