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Koronavirus Hastalığında Yarı Kantitatif Görsel Skorlama ile Mortalite Öngörülebilir Mi?

Yıl 2021, Cilt: 11 Sayı: 1, 91 - 96, 22.03.2021
https://doi.org/10.31832/smj.831560

Öz

AMAÇ: Çalışmamızda Bilgisayarlı tomografi (BT) ile yarı kantitatif bir puanlama yöntemi kullanarak COVID 19 prognozunu tahmin etmeyi amaçlamadık.
GEREÇ VE YÖNTEMLER: 1 Nisan - 25 Haziran 2020 arasında 108 semptomatik COVID-19 hastası taburcu olana veya ölene kadar takip edildi. Akciğer anormalliklerinin paternleri ve dağılımı, toplam BT skorları ve tutulan lobların sayısı için BT görüntüleri değerlendirildi. Lober tutulumun kapsamına göre yarı kantitatif BT skoru hesaplandı (0:% 0; 1:% 5–25; 2:% 26–50; 3:% 51–75; 4,>% 75; aralık 0 –4;toplam puan 0–20). BT skorunun hastaların prognozu üzerindeki prediktif rolü istatistiksel olarak değerlendirildi.
BULGULAR: Toplam BT skoru ortalama 7.47 ± 5.18 idi. 12 hastada BT’de herhangi bir parankimal tutulum görülmedi ve bu nedenle 0 olarak skorlandı. Her akciğer için loblar arasında karşılaştırmalar yapıldı. Sağ akciğerle ilgili olarak, ortalama BT skoru sağ alt lobda orta lobdan (p=0.001) ve üst lobdan (p=0.001) anlamlı olarak yüksekti; ortalama BT skoru sağ orta lobda üst loba göre anlamlı olarak daha yüksekti (p=0.001). Sol akciğerle ilgili olarak ortalama BT skoru sol alt lobda üst lobdan anlamlı olarak yüksekti (p=0.001). Sağ kalanlar grubunun total BT skoru ortalama 5.53±3.94 iken, mortalite grubunda 9.40±5.57 idi. Mortalite grubunun skoru sağ kalanlar grubuna göre anlamlı derecede yüksekti (p=0.001).
SONUÇ: Görüntüleme özellikleri ve dinamik değişiklikler, hastalığın ciddiyetini ve prognozunu hesaplamak için doğrudan bilgi sağlayabilir. BT görüntülemeleri ile yapılan basit puanlama yöntemi, hastaların yönlendirilmesine, yakından izlenmeye veya agresif tedaviye ihtiyaç duyan hastaların belirlenmesine yardımcı olabilir.

Kaynakça

  • 1.Lu H, Stratton CW, Tang YW. Outbreak of pneumonia of unknown etiology in Wuhan, China: The mystery and the miracle. J Med Virol. 2020; 92(4): 401–402. https://doi.org/10.1002/jmv.25678 PMID: 31950516
  • 2.Bogoch II, Watts A, Thomas-Bachli A, et al. Potential for global spread of a novel coronavirus from China. J Travel Med. 2020; 27(2), taaa011. https://doi.org/10.1093/jtm/taaa011 PMID: 31985790.
  • 3.Xie X, Zhong Z, W Zhao, C Zheng, F Wang, J Liu. Chest CT for Typical 2019-nCoV Pneumonia: Relationship to Negative RT-PCR Testing. Radiology. 2020; 200343. Advance online publication. https://doi. org/10.1148/radiol.2020200343
  • 4.Fang Y, Zhang H, Xie J, et al. Sensitivity of Chest CT for COVID-19: Comparison to RT-PCR. Radiolog. 2020; 200432. Advance online publication. https://doi.org/10.1148/radiol.2020200432
  • 5.Zhang B, Zhang J, Chen H, Chen L, Chen Q, Li M, et al. Novel coronavirus disease 2019 (COVID-19): relationship between chest CT scores and laboratory parameters. European Journal of Nuclear Medicine and Molecular Imaging, 2020; 1.
  • 6.Xiong F, Tang H, Liu L, Tu C, Tian JB, Lei CT, Liu J, et al. Clinical characteristics of and medical interventions for COVID-19 in hemodialysis patients in Wuhan, China. J. Am. Soc. Nephrol. 2020; 31: 1387–1397.
  • 7.Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized With COVID-19 in the New York city area. JAMA 2020; 323: 2052–2059.
  • 8. HE, Yueyue. Translation: Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (Trial Version 7): National Health Commission, National Administration of Traditional Chinese Medicine. Infectious Microbes & Diseases. Chin Med J 2020; 133:1087-1095.
  • 9.Kim H. Outbreak of novel coronavirus (COVID-19): what is the role of radiologists? Eur Radiol 2020; Feb 18 [Epub]. https:// doi.org/10.1007/s00330-020-06748-2.
  • 10.Fujioka T, Takahashi M, Mori M, Tsuchiya J, Yamaga E, Horii T, et al. Evaluation of the usefulness of CO-RADS for chest CT in patients suspected of having COVID-19. Diagnostics, 2020; 10(9): 608.
  • 11.Li K, Fang Y, Li W, Pan C, Qin P, Zhong Y, et al. CT image visual quantitative evaluation and clinical classification of coronavirus disease (COVID-19). Eur Radiol 2020; Mar 25 [Epub]. https://doi.org/10.1007/s00330-020-06817-6.
  • 12.Li K, Wu J, Wu F, Guo D, Chen L, Fang Z, et al. The clinical and chest CT features associated with severe and critical COVID-19 pneumonia. Invest Radiol 2020; 55:327-331.
  • 13.Chung M, Bernheim A, Mei X, et al CT imaging features of 2019 novel coronavirus (2019-nCoV). Radiology, 2020; 200230. https:// doi.org/10.1148/radiol.2020200230.
  • 14.Hu Y, Zhan C, Chen C, Ai T, Xia L. Chest CT findings related to mortality of patients with COVID-19: A retrospective case-series study. Plos one, 2020; 15: 8 e0237302.

Can Mortality Be Predicted with Semi-Quantitative Visual Scoring in Coronavirus Disease?

Yıl 2021, Cilt: 11 Sayı: 1, 91 - 96, 22.03.2021
https://doi.org/10.31832/smj.831560

Öz

OBJECTIVE: The study was aimed to predict the COVID 19 prognosis using a semi-quantitative scoring method with computed tomography (CT).
MATERIALS AND METHODS: From April 1 to June 25, 2020, 108 symptomatic COVID-19 patients were enrolled and followed up until they were discharged or died. CT scans were reviewed for the patterns and distribution of lung abnormalities, total CT scores and number of lobes involved. A semi-quantitative CT score was calculated based on the extent of lobar involvement (0:0%; 1:5–25%; 2:26–50%; 3:51–75%; 4, > 75%; range 0–4; global score 0–20). The predictive role of the CT score on the prognosis of the patients was evaluated statistically.
RESULTS: The mean global CT score was 7.47±5.18. 12 patient did not show any parenchymal involvement at CT and was therefore scored as 0. Comparisons have been made between lobes for each lung. Regarding the right lung, mean CT score was significantly higher in right lower lobe than in middle lobe (p=0.001) and right upper lobe (p=0.001); mean CT score was significantly higher in right middle lobe than in upper lobe (p=0.001). Concerning the left lung, mean CT score was significantly higher in left lower lobe than in left upper lobe (p =0.001). Mean global CT score of survival group was 5.53±3.94, while mortal group was 9.40±5.57. The score of mortal group was significantly higher than survival group (p=0.001).
CONCLUSION: The imaging features and dynamic changes could provide the most direct evidence for assessing the severity of the disease and the prognosis. Simple scoring method according to CT scans may help triage patients and screening patients who need more aggressive treatment and closely monitoring.

Kaynakça

  • 1.Lu H, Stratton CW, Tang YW. Outbreak of pneumonia of unknown etiology in Wuhan, China: The mystery and the miracle. J Med Virol. 2020; 92(4): 401–402. https://doi.org/10.1002/jmv.25678 PMID: 31950516
  • 2.Bogoch II, Watts A, Thomas-Bachli A, et al. Potential for global spread of a novel coronavirus from China. J Travel Med. 2020; 27(2), taaa011. https://doi.org/10.1093/jtm/taaa011 PMID: 31985790.
  • 3.Xie X, Zhong Z, W Zhao, C Zheng, F Wang, J Liu. Chest CT for Typical 2019-nCoV Pneumonia: Relationship to Negative RT-PCR Testing. Radiology. 2020; 200343. Advance online publication. https://doi. org/10.1148/radiol.2020200343
  • 4.Fang Y, Zhang H, Xie J, et al. Sensitivity of Chest CT for COVID-19: Comparison to RT-PCR. Radiolog. 2020; 200432. Advance online publication. https://doi.org/10.1148/radiol.2020200432
  • 5.Zhang B, Zhang J, Chen H, Chen L, Chen Q, Li M, et al. Novel coronavirus disease 2019 (COVID-19): relationship between chest CT scores and laboratory parameters. European Journal of Nuclear Medicine and Molecular Imaging, 2020; 1.
  • 6.Xiong F, Tang H, Liu L, Tu C, Tian JB, Lei CT, Liu J, et al. Clinical characteristics of and medical interventions for COVID-19 in hemodialysis patients in Wuhan, China. J. Am. Soc. Nephrol. 2020; 31: 1387–1397.
  • 7.Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized With COVID-19 in the New York city area. JAMA 2020; 323: 2052–2059.
  • 8. HE, Yueyue. Translation: Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (Trial Version 7): National Health Commission, National Administration of Traditional Chinese Medicine. Infectious Microbes & Diseases. Chin Med J 2020; 133:1087-1095.
  • 9.Kim H. Outbreak of novel coronavirus (COVID-19): what is the role of radiologists? Eur Radiol 2020; Feb 18 [Epub]. https:// doi.org/10.1007/s00330-020-06748-2.
  • 10.Fujioka T, Takahashi M, Mori M, Tsuchiya J, Yamaga E, Horii T, et al. Evaluation of the usefulness of CO-RADS for chest CT in patients suspected of having COVID-19. Diagnostics, 2020; 10(9): 608.
  • 11.Li K, Fang Y, Li W, Pan C, Qin P, Zhong Y, et al. CT image visual quantitative evaluation and clinical classification of coronavirus disease (COVID-19). Eur Radiol 2020; Mar 25 [Epub]. https://doi.org/10.1007/s00330-020-06817-6.
  • 12.Li K, Wu J, Wu F, Guo D, Chen L, Fang Z, et al. The clinical and chest CT features associated with severe and critical COVID-19 pneumonia. Invest Radiol 2020; 55:327-331.
  • 13.Chung M, Bernheim A, Mei X, et al CT imaging features of 2019 novel coronavirus (2019-nCoV). Radiology, 2020; 200230. https:// doi.org/10.1148/radiol.2020200230.
  • 14.Hu Y, Zhan C, Chen C, Ai T, Xia L. Chest CT findings related to mortality of patients with COVID-19: A retrospective case-series study. Plos one, 2020; 15: 8 e0237302.
Toplam 14 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Makaleler
Yazarlar

Keziban Karacan 0000-0001-8861-1647

Alper Karacan 0000-0001-8930-9546

Yayımlanma Tarihi 22 Mart 2021
Gönderilme Tarihi 25 Kasım 2020
Yayımlandığı Sayı Yıl 2021 Cilt: 11 Sayı: 1

Kaynak Göster

AMA Karacan K, Karacan A. Can Mortality Be Predicted with Semi-Quantitative Visual Scoring in Coronavirus Disease?. Sakarya Tıp Dergisi. Mart 2021;11(1):91-96. doi:10.31832/smj.831560

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