CT Scoring Method to Predict Mortality of COVID-19 Patients

Priyanshi Patel ‘22

Figure 1. CT scans of patients were compared to predict a cutoff score for mortality rate.

In December 2019, many pneumonia cases linked to seafood and wet animal wholesale emerged in Wuhan, China and now comprise a global pandemic. The virus is related to Middle East Respiratory Syndrome virus (MERS-CoV) and the Severe Acute Respiratory Syndrome virus (SARS-CoV). The novel coronavirus SARS-CoV-2 disease has been named COVID-19 by the World Health Organization (WHO) and has very contagious characteristics. A study was approved by the Institutional Review Boards of Hubei Public Health Center, the central hospital of Wuhan, to collect clinical and radiologic characteristics of 27 confirmed cases and analyze the association between radiological findings and mortality cases. 

Clinical characteristics and CT images were collected from 27 patients who were confirmed to have novel coronavirus-infected pneumonia (NCIP). 27 patients included 12 men and 15 women, averaging around 60 years of age. 17 patients were discharged in a recovery condition and 10 died in the hospital. Diagnosis of NCIP in the patients was made by a positive test for viral 2019-nCoV viral RNA and in-throat swab specimens. All patients were treated with intravenous ribavirin, oral oseltamivir, and antibiotics. CT examinations were also conducted on the patients. 

CT findings included ground glass opacity (GGO), defined as hazy areas of increased opacity without concealing underlying vessels. CT scans of NCIP patients featured predominantly GGO (67%). GGOs and airspace lesions which were conspicuous characteristics of the three kinds of viral pneumonia. The CT scores were higher in the mortality group (30) than the survival group (12). The scores of the mortality group increased from 12 to 20 in a short time, suggesting a progressive course of NCIP. The researchers found an optimal cutoff value of a CT score of 24.5 to predict mortality and hope that a simple scoring method can help patients with being screened. The efficacy to decrease mortality rate must be validated in future studies. 

References: 

  1. M. Yuan, et. al., Association of radiologic findings with mortality of patients infected with 2019 novel coronavirus in Wuhan, China. PLoS One, 1-10 (2020). doi: 10.1371/journal.pone.0230548 
  2. Image Retrieved from: https://www.gettyimages.com/detail/photo/brain-scan-of-head-and-skull-with-hand-pointing-royalty-free-image/97873871?adppopup=true

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