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Association of chest computed tomography severity score at ICU admission and respiratory outcomes in critically ill COVID-19 patients.
Esper Treml, Ricardo; Caldonazo, Tulio; Barlem Hohmann, Fábio; Lima da Rocha, Daniel; Filho, Pedro Hilton A; Mori, Andréia L; S Carvalho, André; S F Serrano, Juliana; A T Dall-Aglio, Pedro; Radermacher, Peter; Silva, João M.
Afiliação
  • Esper Treml R; Department of Anesthesiology and Intensive Care Medicine, Friedrich-Schiller-University, Jena, Germany.
  • Caldonazo T; Department of Anesthesiology, University of São Paulo, São Paulo, Brazil.
  • Barlem Hohmann F; Department of Cardiothoracic Surgery, Friedrich-Schiller-University, Jena, Germany.
  • Lima da Rocha D; Department of Intensive Care Medicine, Hospital Israelita Albert Einstein, São Paulo, Brazil.
  • Filho PHA; Department of Intensive Care Medicine, Hospital Israelita Albert Einstein, São Paulo, Brazil.
  • Mori AL; Department of Anesthesiology, Servidor Público Estadual Hospital, Sao Paulo, Brazil.
  • S Carvalho A; Department of Anesthesiology, Servidor Público Estadual Hospital, Sao Paulo, Brazil.
  • S F Serrano J; Department of Anesthesiology, Servidor Público Estadual Hospital, Sao Paulo, Brazil.
  • A T Dall-Aglio P; Department of Anesthesiology, Servidor Público Estadual Hospital, Sao Paulo, Brazil.
  • Radermacher P; Department of Anesthesiology, Servidor Público Estadual Hospital, Sao Paulo, Brazil.
  • Silva JM; Institute for Anesthesiological Pathophysiology and Process Development, Ulm University Hospital, Ulm, Germany.
PLoS One ; 19(5): e0299390, 2024.
Article em En | MEDLINE | ID: mdl-38696477
ABSTRACT

OBJECTIVE:

To evaluate the association of a validated chest computed tomography (Chest-CT) severity score in COVID-19 patients with their respiratory outcome in the Intensive Care Unit.

METHODS:

A single-center, prospective study evaluated patients with positive RT-PCR for COVID-19, who underwent Chest-CT and had a final COVID-19 clinical diagnosis needing invasive mechanical ventilation in the ICU. The admission chest-CT was evaluated according to a validated Chest-CT Severity Score in COVID-19 (Chest-CTSS) divided into low ≤50% (<14 points) and >50% high (≥14 points) lung parenchyma involvement. The association between the initial score and their pulmonary clinical outcomes was evaluated.

RESULTS:

121 patients were clustered into the > 50% lung involvement group and 105 patients into the ≤ 50% lung involvement group. Patients ≤ 50% lung involvement (<14 points) group presented lower PEEP levels and FiO2 values, respectively GEE P = 0.09 and P = 0.04. The adjusted COX model found higher hazard to stay longer on invasive mechanical ventilation HR 1.69, 95% CI, 1.02-2.80, P = 0.042 and the adjusted logistic regression model showed increased risk ventilator-associated pneumonia OR = 1.85 95% CI 1.01-3.39 for COVID-19 patients with > 50% lung involvement (≥14 points) on Chest-CT at ICU admission.

CONCLUSION:

COVID-19 patients with >50% lung involvement on Chest-CT admission presented higher chances to stay longer on invasive mechanical ventilation and more chances to developed ventilator-associated pneumonia.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Respiração Artificial / Índice de Gravidade de Doença / Tomografia Computadorizada por Raios X / Estado Terminal / COVID-19 / Unidades de Terapia Intensiva Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Respiração Artificial / Índice de Gravidade de Doença / Tomografia Computadorizada por Raios X / Estado Terminal / COVID-19 / Unidades de Terapia Intensiva Idioma: En Ano de publicação: 2024 Tipo de documento: Article