Predictive value of initial CT scan for various adverse outcomes in patients with COVID-19 pneumonia.
Bardia Khosravi, Leila Aghaghazvini, Majid Sorouri and 11 others
PMID 33097297WHAT IT FOUND
Hospitalized adults with COVID-19 pneumonia and a baseline CT severity score above 8 had higher odds of ICU admission, intubation, and death.
The score was not associated with length of stay.
Key findings
01A CT severity score above 8 was positively associated with ICU admission, intubation, and death.
02Reticular pattern on the initial CT scan was associated with lower odds of ICU admission and death.
03The CT severity score was not associated with length of stay.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was retrospective and done at one hospital in Iran, so the score may not work the same in other settings. Only patients discharged by April 19 were included, so people still hospitalized at the end of the study were excluded. Eighteen patients without RT-PCR testing were excluded, and early false-negative RT-PCR results may have affected who entered the analysis. The radiologists were experienced in reporting suspected COVID-19 scans, and the study did not re-check scans for intra-observer reliability. The adjusted odds ratios had wide confidence intervals, so precision is limited. The authors call for further prospective studies and research on treatment regimens by CT severity group, so the score has not been shown to guide care.
Declared interests
The authors declared no competing interests.
The easy way to misread this
Do not conclude that a high CT severity score alone should trigger ICU transfer or ventilation. This was a retrospective association in 121 patients, not a tested decision rule, and the score did not predict length of stay.