Risk Factors for Poor Outcome in Patients with Severe Viral Pneumonia on Chest CT during the COVID-19 Outbreak: a Perspective from Iran.

• Type of Material: Article
• Authors: Amir Davarpanah, Emory University; Reyhaneh Asgari, Shahid Beheshti University of Medical Sciences; Yashar Moharamzad, Shahid Beheshti University of Medical Sciences; Arash Mahdavi, Shahid Beheshti University of Medical Sciences; Alireza Abrishami, Shahid Beheshti University of Medical Sciences; Sayyedmojtaba Nekooghadam, Shahid Beheshti University of Medical Sciences; Ali Sabri, McMaster University; Ehsan Zarei, Shahid Beheshti University of Medical Sciences; Mehdi Khazaei, Shahid Beheshti University of Medical Sciences; Morteza Sanei Taheri, Shahid Beheshti University of Medical Sciences
• Language: English
• Date: 2020-08-19
• Publisher: Springer
• Publication Version: Final Published Version
• Copyright Statement: © Springer Nature Switzerland AG 2020
• Final Published Version (URL): http://dx.doi.org/10.1007/s42399-020-00445-3
• Title of Journal or Parent Work: SN Compr Clin Med
• Start Page: 1
• End Page: 11
• Grant/Funding Information: No fund was received to conduct this study.
• Keywords: Pneumonia; COVID-19; Patient outcome assessment; Tomography, X-ray computed; Prognosis
• Research Categories: Biology, Virology; Health Sciences, Public Health; Health Sciences, Radiology

Abstract

We investigated significant predictors of poor in-hospital outcomes for patients admitted with viral pneumonia during the COVID-19 outbreak in Tehran, Iran. Between February 22 and March 22, 2020, patients who were admitted to three university hospitals during the COVID-19 outbreak in Tehran, Iran were included. Demographic, clinical, laboratory, and chest CT scan findings were gathered. Two radiologists evaluated the distribution and CT features of the lesions and also scored the extent of lung involvement as the sum of three zones in each lung. Of 228 included patients, 45 patients (19.7%) required ICU admission and 34 patients (14.9%) died. According to regression analysis, older age (OR = 1.06; P < 0.001), blood oxygen saturation (SpO2) < 88% (OR = 2.88; P = 0.03), and higher chest CT total score (OR = 1.10; P = 0.03) were significant predictors for in-hospital death. The same three variables were also recognized as significant predictors for invasive respiratory support: SpO2 < 88% (OR = 3.97, P = 0.002), older age (OR = 1.05, P < 0.001), and higher CT total score (OR = 1.13, P = 0.008). Potential predictors of invasive respiratory support and in-hospital death in patients with viral pneumonia were older age, SpO2 < 88%, and higher chest CT score.