NGHIÊN CỨU GIÁ TRỊ ĐẶC ĐIỂM DẠNG TỔN THƯƠNG TRÊN CẮT LỚP VI TÍNH PHỔI TRONG TIÊN LƯỢNG BỆNH COVID - 19

Abstract

Objective: To analyze the correlation between different lung lesion patterns on pulmonary computed tomography (CT) and severe clinical prognosis in COVID-19 patients. Subjects and Methods: A retrospective descriptive study including 160 patients diagnosed with COVID-19 by reverse transcription polymerase chain reaction (RT-PCR) testing, with complete medical history information available in electronic medical records, who underwent chest CT scans upon hospital admission at the COVID-19 Treatment Hospital under Hanoi Medical University Hospital from September 2021 to January 2023. Results: Ground-glass opacity (GGO) did not correlate with severe disease progression (mechanical ventilation p = 0.74, ICU admission p = 0.999, mortality p = 0.999). Consolidation, crazy paving, and pleural effusion were significantly associated with higher risks of mechanical ventilation, ICU admission, and mortality compared to other groups [consolidation: 8.8 times (p < 0.001), 2 times (p = 0.022), 2.4 times (p = 0.046); crazy paving: 2.8 times (p = 0.049), 4.2 times (p = 0.049), and 2.3 times (p = 0.031); pleural effusion: 2.4 times (p = 0.027), 1.5 times (p = 0.031), and 2.1 times (p = 0.018)]. Interstitial thickening, vascular enlargement, and bronchiectasis were also associated with increased risk of mechanical ventilation [interstitial thickening: 3.0 times (p = 0.017); vascular enlargement: 3.6 times (p = 0.002); bronchiectasis: 6.9 times (p = 0.002)]. Pericardial effusion increased the risk of ICU admission by 3.8 times compared to the non-effusion group (p = 0.031). Pneumothorax increased mortality risk by 3.7 times compared to the non-pneumothorax group (p = 0.012). The reversed halo sign, nodules, cavitation, and enlarged lymph nodes were not identified as independent prognostic factors in COVID-19 patients. Conclusion: CT imaging features associated with severe clinical prognosis include consolidation, vascular enlargement, crazy paving, bronchiectasis, pleural effusion, pericardial effusion, and pneumothorax.