Imaging-based indices combining disease severity and time from disease onset to predict COVID-19 mortality: A cohort study
<h4>Background</h4> COVID-19 prognostic factors include age, sex, comorbidities, laboratory and imaging findings, and time from symptom onset to seeking care. <h4>Purpose</h4> The study aim was to evaluate indices combining disease severity measures and time from disease onse...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2022-01-01
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| Series: | PLoS ONE |
| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9202871/?tool=EBI |
| _version_ | 1828812875014078464 |
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| author | Giulia Besutti Olivera Djuric Marta Ottone Filippo Monelli Patrizia Lazzari Francesco Ascari Guido Ligabue Giovanni Guaraldi Giuseppe Pezzuto Petra Bechtold Marco Massari Ivana Lattuada Francesco Luppi Maria Giulia Galli Pierpaolo Pattacini Paolo Giorgi Rossi |
| author_facet | Giulia Besutti Olivera Djuric Marta Ottone Filippo Monelli Patrizia Lazzari Francesco Ascari Guido Ligabue Giovanni Guaraldi Giuseppe Pezzuto Petra Bechtold Marco Massari Ivana Lattuada Francesco Luppi Maria Giulia Galli Pierpaolo Pattacini Paolo Giorgi Rossi |
| author_sort | Giulia Besutti |
| collection | DOAJ |
| description | <h4>Background</h4> COVID-19 prognostic factors include age, sex, comorbidities, laboratory and imaging findings, and time from symptom onset to seeking care. <h4>Purpose</h4> The study aim was to evaluate indices combining disease severity measures and time from disease onset to predict mortality of COVID-19 patients admitted to the emergency department (ED). <h4>Materials and methods</h4> All consecutive COVID-19 patients who underwent both computed tomography (CT) and chest X-ray (CXR) at ED presentation between 27/02/2020 and 13/03/2020 were included. CT visual score of disease extension and CXR Radiographic Assessment of Lung Edema (RALE) score were collected. The CT- and CXR-based scores, C-reactive protein (CRP), and oxygen saturation levels (sO2) were separately combined with time from symptom onset to ED presentation to obtain severity/time indices. Multivariable regression age- and sex-adjusted models without and with severity/time indices were compared. For CXR-RALE, the models were tested in a validation cohort. <h4>Results</h4> Of the 308 included patients, 55 (17.9%) died. In multivariable logistic age- and sex-adjusted models for death at 30 days, severity/time indices showed good discrimination ability, higher for imaging than for laboratory measures (AUCCT = 0.92, AUCCXR = 0.90, AUCCRP = 0.88, AUCsO2 = 0.88). AUCCXR was lower in the validation cohort (0.79). The models including severity/time indices performed slightly better than models including measures of disease severity not combined with time and those including the Charlson Comorbidity Index, except for CRP-based models. <h4>Conclusion</h4> Time from symptom onset to ED admission is a strong prognostic factor and provides added value to the interpretation of imaging and laboratory findings at ED presentation. |
| first_indexed | 2024-12-12T09:51:09Z |
| format | Article |
| id | doaj.art-87e5dd252a2343ccafcc6608b9497529 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-12T09:51:09Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-87e5dd252a2343ccafcc6608b94975292022-12-22T00:28:16ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01176Imaging-based indices combining disease severity and time from disease onset to predict COVID-19 mortality: A cohort studyGiulia BesuttiOlivera DjuricMarta OttoneFilippo MonelliPatrizia LazzariFrancesco AscariGuido LigabueGiovanni GuaraldiGiuseppe PezzutoPetra BechtoldMarco MassariIvana LattuadaFrancesco LuppiMaria Giulia GalliPierpaolo PattaciniPaolo Giorgi Rossi<h4>Background</h4> COVID-19 prognostic factors include age, sex, comorbidities, laboratory and imaging findings, and time from symptom onset to seeking care. <h4>Purpose</h4> The study aim was to evaluate indices combining disease severity measures and time from disease onset to predict mortality of COVID-19 patients admitted to the emergency department (ED). <h4>Materials and methods</h4> All consecutive COVID-19 patients who underwent both computed tomography (CT) and chest X-ray (CXR) at ED presentation between 27/02/2020 and 13/03/2020 were included. CT visual score of disease extension and CXR Radiographic Assessment of Lung Edema (RALE) score were collected. The CT- and CXR-based scores, C-reactive protein (CRP), and oxygen saturation levels (sO2) were separately combined with time from symptom onset to ED presentation to obtain severity/time indices. Multivariable regression age- and sex-adjusted models without and with severity/time indices were compared. For CXR-RALE, the models were tested in a validation cohort. <h4>Results</h4> Of the 308 included patients, 55 (17.9%) died. In multivariable logistic age- and sex-adjusted models for death at 30 days, severity/time indices showed good discrimination ability, higher for imaging than for laboratory measures (AUCCT = 0.92, AUCCXR = 0.90, AUCCRP = 0.88, AUCsO2 = 0.88). AUCCXR was lower in the validation cohort (0.79). The models including severity/time indices performed slightly better than models including measures of disease severity not combined with time and those including the Charlson Comorbidity Index, except for CRP-based models. <h4>Conclusion</h4> Time from symptom onset to ED admission is a strong prognostic factor and provides added value to the interpretation of imaging and laboratory findings at ED presentation.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9202871/?tool=EBI |
| spellingShingle | Giulia Besutti Olivera Djuric Marta Ottone Filippo Monelli Patrizia Lazzari Francesco Ascari Guido Ligabue Giovanni Guaraldi Giuseppe Pezzuto Petra Bechtold Marco Massari Ivana Lattuada Francesco Luppi Maria Giulia Galli Pierpaolo Pattacini Paolo Giorgi Rossi Imaging-based indices combining disease severity and time from disease onset to predict COVID-19 mortality: A cohort study PLoS ONE |
| title | Imaging-based indices combining disease severity and time from disease onset to predict COVID-19 mortality: A cohort study |
| title_full | Imaging-based indices combining disease severity and time from disease onset to predict COVID-19 mortality: A cohort study |
| title_fullStr | Imaging-based indices combining disease severity and time from disease onset to predict COVID-19 mortality: A cohort study |
| title_full_unstemmed | Imaging-based indices combining disease severity and time from disease onset to predict COVID-19 mortality: A cohort study |
| title_short | Imaging-based indices combining disease severity and time from disease onset to predict COVID-19 mortality: A cohort study |
| title_sort | imaging based indices combining disease severity and time from disease onset to predict covid 19 mortality a cohort study |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9202871/?tool=EBI |
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