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Stratifying the early radiologic trajectory in dyspneic patients with COVID-19 pneumonia

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Author(s)
Jin Young KimKeum Ji JungSeung-Jin YooSoon Ho Yoon
Keimyung Author(s)
Kim, Jin Young
Department
Dept. of Radiology (영상의학)
Journal Title
PLoS One
Issued Date
2021
Volume
16
Issue
10
Abstract
Objective:
This study aimed to stratify the early pneumonia trajectory on chest radiographs and compare patient characteristics in dyspneic patients with coronavirus disease 2019 (COVID-19).

Materials and methods:
We retrospectively included 139 COVID-19 patients with dyspnea (87 men, 62.7±16.3 years) and serial chest radiographs from January to September 2020. Radiographic pneumonia extent was quantified as a percentage using a previously-developed deep learning algorithm. A group-based trajectory model was used to categorize the pneumonia trajectory after symptom onset during hospitalization. Clinical findings, and outcomes were compared, and Cox regression was performed for survival analysis.

Results:
Radiographic pneumonia trajectories were categorized into four groups. Group 1 (n = 83, 59.7%) had negligible pneumonia, and group 2 (n = 29, 20.9%) had mild pneumonia. Group 3 (n = 13, 9.4%) and group 4 (n = 14, 10.1%) showed similar considerable pneumonia extents at baseline, but group 3 had decreasing pneumonia extent at 1–2 weeks, while group 4 had increasing pneumonia extent. Intensive care unit admission and mortality were significantly more frequent in groups 3 and 4 than in groups 1 and 2 (P < .05). Groups 3 and 4 shared similar clinical and laboratory findings, but thrombocytopenia (<150×103/μL) was exclusively observed in group 4 (P = .016). When compared to groups 1 and 2, group 4 (hazard ratio, 63.3; 95% confidence interval, 7.9–504.9) had a two-fold higher risk for mortality than group 3 (hazard ratio, 31.2; 95% confidence interval, 3.5–280.2), and this elevated risk was maintained after adjusting confounders.

Conclusion:
Monitoring the early radiologic trajectory beyond baseline further prognosticated at-risk COVID-19 patients, who potentially had thrombo-inflammatory responses.
Keimyung Author(s)(Kor)
김진영
Publisher
School of Medicine (의과대학)
Citation
Jin Young Kim et al. (2021). Stratifying the early radiologic trajectory in dyspneic patients with COVID-19 pneumonia. PLoS One, 16(10), e0259010. doi: 10.1371/journal.pone.0259010
Type
Article
ISSN
1932-6203
Source
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0259010
DOI
10.1371/journal.pone.0259010
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44060
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Radiology (영상의학)
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