Association Between CT Scan Findings and Mortality in Covid-19 Cases

Background: Covid-19 epidemia is a worldwide infectious viral disease initiating from December 2019 from Wuhan, China. Recognition of the prognostic role of imaging findings is important to improve the outcomes in patients. Accordingly, regarding the lack of studies in this era among Iranian patients, this study was done to determine the association between CT scan findings and mortality in Covid-19 cases. Methods: In this prognostic prospective cohort study, 192 consecutive patients with established Covid-19 disease by clinical findings, and laboratory results in Besat Hospital, Tehran, Iran in March and April 2020 were enrolled. The findings in CT scan were involved zone and lobe, ground glass, consolidation, ground glass with reticular, reverse hallo sign, microvascular dilation sign, fibrotic streaks, sub pleural line, air bronchogram, Bronchus distortion, broncheiectasis, pleural thickening, pleural reaction, and pleural effusion. According to involvement degree the points in CT scan were 0, 1, and 2 for lack of lung parenchyma involvement, less than 50 percent involvement, and more than 50 percent involvement. Results: The involved zones were significantly differed between survived and dead cases (P=0.001). As shown in Table 4, the scores of CT scan for lung involvement and also number of involved lobes were differed across the alive and dead cases (P=0.001) the mean hospital stay was 7.1 (5.6) and 5.7 (2.5) days that was same across the groups (P=0.325). There were significant differences between groups for consolidation, ground glass plus reticular pattern, fibrotic streaks, sub-pleural line, air bronchogram, bronchiectasis, pleural thickening, pleural effusion, and pleural reaction (P < 0.05). Conclusion: Totally, according to the obtained results it may be concluded that CT scan is useful prognostic modality to predict the mortality among patients with Covid-19 disease. Consolidation, ground glass plus reticular pattern, fibrotic streaks, sub-pleural line, air bronchogram, bronchiectasis, pleural thickening, pleural effusion, and pleural reaction are the man CT scan findings predicting higher mortality rate in these patients.