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Does the Thymus Index Predict COVID-19 Severity?
Ocal Berkan1, Ilker Kiziloğlu2, Ercan Keles1
1From the Departments of Cardiovascular Surgery.
Journal of Computer Assisted Tomography
|February 2, 2023
Summary
The thymus index (TI) on chest CT scans can predict COVID-19 severity and mortality. A normal thymus appearance is linked to better outcomes, aiding resource allocation during the pandemic.
Area of Science:
- Radiology
- Immunology
- Infectious Diseases
Background:
- The COVID-19 pandemic strains healthcare resources globally.
- Identifying patients at high risk for severe illness is crucial for effective resource management.
- This study explores the prognostic value of the thymus index (TI) in COVID-19 patients.
Purpose of the Study:
- To investigate the association between the thymus index (TI) on thorax computed tomography (CT) and prognosis in COVID-19 patients.
- To determine if TI can predict disease severity and mortality.
- To evaluate the utility of thymic morphology in assessing COVID-19 outcomes.
Main Methods:
- A multicenter, retrospective study of 1231 COVID-19 patients with thoracic CT imaging.
- Radiologists assessed thymus appearance using the thymus index (TI) and thymic morphology, blinded to clinical data.
- Multivariable analysis predicted severe disease and mortality risk.
Main Results:
- Thymus index (TI) was significantly associated with reduced mortality (OR 0.289, P=0.001) and severe disease (OR 0.266, P=0.038).
- Perithymic lymphadenopathy correlated with higher TI grades in severe disease and fatal cases.
- A morphologically assessable thymus increased survival probability 17-fold and reduced severe disease likelihood 12-fold.
Conclusions:
- Thymus assessment via CT provides valuable prognostic data for COVID-19.
- TI and thymic morphology can aid in predicting disease severity and mortality.
- This non-invasive imaging marker can inform clinical management and resource allocation.
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