Summary: | Aim. To evaluate mean Hounsfield unit calculation (HUAC), bone density,
subcutaneous fat thickness (SFT), breast density (constitutional imaging
biomarkers) and age in symptomatic patients with COVID-19, to assess their
correlation with pneumonia severity. Materials and Methods. Between 11
March and 30 May 2020, 272 consecutive symptomatic female patients with
COVID-19 who underwent chest CT imaging at baseline were reviewed.
HUAC, bone density, SFT and breast density were evaluated retrospectively and
statistically compared in cases with negative/positive PCR test results,
with/without pneumonia and with mild/moderate-severe pneumonia.
Univariate/multivariate logistic regression analyses were applied for estimation
of moderate/severe pneumonia. Results. The parameters of age, HUAC, bone
density, SFT and breast density were significantly different between patients
with/without pneumonia. Additionally, the patients with moderate-severe
pneumonia were older, had lower bone density, lower HUAC values, greater
SFT and mostly fatty breast density. ROC analysis showed the highest AUC
values of 0.763 and 0.744 for age and HUAC, respectively. A combination of
HUAC and age was the most accurate model for estimation of moderate/severe
pneumonia on logistic regression. Good intraobserver and interobserver
reliabilities were detected. Conclusions. The severity of COVID-19 pneumonia
among adult females was associated with older age, lower bone density, a lower
HUAC value, greater SFT and fatty breast parenchyma. All these factors can be
responsible for 21.9% of the development of moderate/severe pneumonia.
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