The prognostic value of pneumonia severity score and pectoralis muscle Area on chest CT in adult COVID-19 patients

• Published in: European journal of radiology 2020-10, Vol.131, p.109271-109271, Article 109271
• Main Authors: Ufuk, Furkan, Demirci, Mahmut, Sagtas, Ergin, Akbudak, Ismail Hakkı, Ugurlu, Erhan, Sari, Tugba
• Format: Article
• Language: English
• Subjects: Adult; Betacoronavirus; Computed tomography; Coronavirus Infections - diagnostic imaging; COVID-19; Female; Humans; Male; Middle Aged; Pandemics; Pectoralis Muscles - diagnostic imaging; Pneumonia; Pneumonia, Viral - diagnostic imaging; Prognosis; Retrospective Studies; Sarcopenia; SARS-CoV-2; Severity of Illness Index; Thorax - diagnostic imaging; Tomography, X-Ray Computed
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2020.109271

•High PSS on chest CT is associated with poor outcomes in COVID-19 patients.•Low PMA and PMI on chest CT is associated with poor outcomes in COVID-19.•Late admission to the hospital is associated with poor outcomes in COVID-19.•Diabetes and high fever at admission are associated with poor outcomes in COVID-19.•Being > 65 years old is an independent risk factor for intubation in COVID-19. To assess the prognostic value of pneumonia severity score (PSS), pectoralis muscle area (PMA), and index (PMI) on chest computed tomography (CT) in adult coronavirus disease 2019 (COVID-19) patients. The chest CT images of COVID-19 patients were evaluated for the PSS as the ratio of the volume of involved lung parenchyma to the total lung volume. The cross-sectional areas of the pectoralis muscles (PMA, cm2) were also measured automatically on axial CT images, and PMI was calculated as the following formula: PMI = PMA / patient’s height square (m2). The relationship between clinical variables, PSS, PMA, sex-specific PMI values, and patient outcomes (intubation, prolonged hospital stay, and death) were investigated using multivariable logistic regression analysis. All patients were followed for more than a month. One-hundred thirty patients (76 males, 58.46 %) were included in the study. Fifteen patients (11.54 %) were intubated, 24 patients (18.46 %) had prolonged hospital stay, and eight patients (6.15 %) died during follow-up. Patients with comorbidity had a higher mean of PSS (6.3 + 4.5 vs 3.9 + 3.8; p = 0.001). After adjusting the confounders, PSS was an independent predictor of intubation (adjusted Odds Ratio [OR]: 1.73, 95 % CI 1.31−2.28, p