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Impact of Computed Tomography-Quantified Emphysema Score on Clinical Outcome in Patients with COVID-19

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Affiliated Author(s)
김진영
Alternative Author(s)
Kim, Jin Young
Journal Title
Int J Gen Med
ISSN
1178-7074
Issued Date
2021
Keyword
COVID-19emphysemacomputed tomography COPDmortality
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.
Department
Dept. of Radiology (영상의학)
Publisher
School of Medicine (의과대학)
Citation
Jae-Kwang Lim et al. (2021). Impact of Computed Tomography-Quantified Emphysema Score on Clinical Outcome in Patients with COVID-19. Int J Gen Med, 14, 3327–3333. doi: 10.2147/IJGM.S317295
Type
Article
ISSN
1178-7074
DOI
10.2147/IJGM.S317295
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43949
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Radiology (영상의학)
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