Utility of Early Chest Computed Tomography to Assess COVID-19 Prognosis: A Retrospective Cohort of 166 Hospitalized Patients in Southern Iran

Abstract

Background: Chest computed tomography (CT)-derived findings pose clinical value in detecting high-risk COVID-19 patients. Objectives: This retrospective cohort study aimed to assess poor hospital prognosis in COVID-19 patients using on-admission chest CT findings. Methods: This study included 166 hospitalized COVID-19 patients with a confirmed diagnosis of COVID-19 from October to December 2020 in Southern Iran. Demographic variables, on-admission clinical and laboratory data, and on-admission high-resolution chest CT (HRCT) such as visual lung involvement score, distribution, area, main pattern, and related features, as well as short-term follow-up during the hospital stay, were extracted. Poor prognosis was defined as ICU admission, need for invasive mechanical ventilation, development of acute respiratory distress syndrome, or death. Results: The COVID-19 patients with poor prognosis had a significantly higher visual lung involvement score compared to those without poor prognosis (20 [IQR: 14, 23] vs. 13 [IQR: 10, 17]; P < 0.0001). The two groups were not statistically different for other HRCT findings. In a multivariable model, lung involvement score was the only statistically significant independent variable for in-patient COVID-19 poor prognosis (odds ratio: 1.197 [95% confidence interval: 1.064, 1.348]; P = 0.003). Conclusions: On-admission chest CT findings can potentially be utilized to evaluate prognosis and guide the treatment strategy of hospitalized COVID-19 patients as early as during the emergency ward stay.