Clinical importance of thoracal lymphadenopathy in COVID-19

Background: Thoracal lymphadenopathy may predict prognosis in patients with coronavirus disease 2019 (COVID-19), albeit the reported data is inconclusive. The aim of the present analysis was to analyze the affected lymph node stations and the cumulative lymph node size derived from computed tomograp...

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Main Authors: Hans-Jonas Meyer, Bohdan Melekh, Andreas Wienke, Jan Borggrefe, Alexey Surov
Format: Article
Language:English
Published: Elsevier 2023-08-01
Series:Journal of Infection and Public Health
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1876034123001867
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author Hans-Jonas Meyer
Bohdan Melekh
Andreas Wienke
Jan Borggrefe
Alexey Surov
author_facet Hans-Jonas Meyer
Bohdan Melekh
Andreas Wienke
Jan Borggrefe
Alexey Surov
author_sort Hans-Jonas Meyer
collection DOAJ
description Background: Thoracal lymphadenopathy may predict prognosis in patients with coronavirus disease 2019 (COVID-19), albeit the reported data is inconclusive. The aim of the present analysis was to analyze the affected lymph node stations and the cumulative lymph node size derived from computed tomography (CT) for prediction of 30-day mortality in patients with COVID-19. Methods: The clinical database was retrospectively screened for patients with COVID-19 between 2020 and 2022. Overall, 177 patients (63 female, 35.6%) were included into the analysis. Thoracal lymphadenopathy was defined by short axis diameter above 10 mm. Cumulative lymph node size of the largest lymph nodes was calculated and the amount of affected lymph node stations was quantified. Results: Overall, 53 patients (29.9%) died within the 30-day observation period. 108 patients (61.0%) were admitted to the ICU and 91 patients needed to be intubated (51.4%). Overall, there were 130 patients with lymphadenopathy (73.4%). The mean number of affected lymph node levels were higher in non-survivors compared to survivors (mean, 4.0 vs 2.2, p < 0.001). The cumulative size was also higher in non-survivors compared to survivors (mean 55.9 mm versus 44.1 mm, p = 0.006). Presence of lymphadenopathy was associated with 30-day mortality in a multivariable analysis, OR = 2.99 (95% CI 1.20 – 7.43), p = 0.02. Conclusions: Thoracal lymphadenopathy comprising cumulative size and affected levels derived from CT images is associated with 30-day mortality in patients with COVID-19. COVID-19 patients presenting with thoracic lymphadenopathy should be considered as a risk group.
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spelling doaj.art-010873c5ecd54a1c9ee152d0082b4f5d2023-07-06T04:17:33ZengElsevierJournal of Infection and Public Health1876-03412023-08-0116812441248Clinical importance of thoracal lymphadenopathy in COVID-19Hans-Jonas Meyer0Bohdan Melekh1Andreas Wienke2 Jan Borggrefe3Alexey Surov4Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, Germany; Correspondence to: Department of Diagnostic and Interventional Radiology University of Leipzig, Germany.Department of Radiology and Nuclear Medicine, University of Magdeburg, Magdeburg, GermanyInstitute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), GermanyRadiology and Nuclear Medicine, Kreisklinikum Minden, University of Bochum, Bochum, GermanyDepartment of Radiology and Nuclear Medicine, University of Magdeburg, Magdeburg, Germany; Radiology and Nuclear Medicine, Kreisklinikum Minden, University of Bochum, Bochum, GermanyBackground: Thoracal lymphadenopathy may predict prognosis in patients with coronavirus disease 2019 (COVID-19), albeit the reported data is inconclusive. The aim of the present analysis was to analyze the affected lymph node stations and the cumulative lymph node size derived from computed tomography (CT) for prediction of 30-day mortality in patients with COVID-19. Methods: The clinical database was retrospectively screened for patients with COVID-19 between 2020 and 2022. Overall, 177 patients (63 female, 35.6%) were included into the analysis. Thoracal lymphadenopathy was defined by short axis diameter above 10 mm. Cumulative lymph node size of the largest lymph nodes was calculated and the amount of affected lymph node stations was quantified. Results: Overall, 53 patients (29.9%) died within the 30-day observation period. 108 patients (61.0%) were admitted to the ICU and 91 patients needed to be intubated (51.4%). Overall, there were 130 patients with lymphadenopathy (73.4%). The mean number of affected lymph node levels were higher in non-survivors compared to survivors (mean, 4.0 vs 2.2, p < 0.001). The cumulative size was also higher in non-survivors compared to survivors (mean 55.9 mm versus 44.1 mm, p = 0.006). Presence of lymphadenopathy was associated with 30-day mortality in a multivariable analysis, OR = 2.99 (95% CI 1.20 – 7.43), p = 0.02. Conclusions: Thoracal lymphadenopathy comprising cumulative size and affected levels derived from CT images is associated with 30-day mortality in patients with COVID-19. COVID-19 patients presenting with thoracic lymphadenopathy should be considered as a risk group.http://www.sciencedirect.com/science/article/pii/S1876034123001867Mediastinal lymph nodeCTCOVID-19
spellingShingle Hans-Jonas Meyer
Bohdan Melekh
Andreas Wienke
Jan Borggrefe
Alexey Surov
Clinical importance of thoracal lymphadenopathy in COVID-19
Journal of Infection and Public Health
Mediastinal lymph node
CT
COVID-19
title Clinical importance of thoracal lymphadenopathy in COVID-19
title_full Clinical importance of thoracal lymphadenopathy in COVID-19
title_fullStr Clinical importance of thoracal lymphadenopathy in COVID-19
title_full_unstemmed Clinical importance of thoracal lymphadenopathy in COVID-19
title_short Clinical importance of thoracal lymphadenopathy in COVID-19
title_sort clinical importance of thoracal lymphadenopathy in covid 19
topic Mediastinal lymph node
CT
COVID-19
url http://www.sciencedirect.com/science/article/pii/S1876034123001867
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