Characteristics of patients with COVID-19 who have deteriorating chest X-ray findings within 48 h: a retrospective

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Lung CT Segmentation to Identify Consolidations and Ground Glass Areas for Quantitative Assesment of SARS-CoV Pneumonia
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Published on: December 19, 2020

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Tatsuya Kusumoto1, Shotaro Chubachi2, Ho Namkoong3

  • 1Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.

Scientific Reports
|December 12, 2023
PubMed

Insights

Worsening chest X-ray findings in coronavirus disease 2019 (COVID-19) patients predict severe outcomes. Early hospitalization pulmonary infiltrate progression is a key risk factor for mortality and critical illness.

Area of Science:

  • Medical research
  • Pulmonology
  • Infectious diseases

Background:

  • Chest X-ray (CXR) severity is a prognostic indicator in COVID-19.
  • Understanding early hospitalization changes in CXR is crucial for patient outcomes.

Purpose of the Study:

  • To investigate clinical and genetic factors associated with worsening CXR findings during early hospitalization for COVID-19.
  • To identify risk factors for rapid CXR deterioration and its prognostic implications.

Main Methods:

  • Retrospective analysis of 1656 Japanese COVID-19 patients.
  • Definition of rapid CXR deterioration: increased pulmonary infiltrates (≥50% lung fields) within 48 hours of admission.
  • Statistical analysis to identify independent risk factors and genetic associations.

Main Results:

  • Rapid CXR deterioration independently predicted death, severe illness, intubation, and ICU admission.
  • Risk factors for rapid deterioration included consolidation, cardiovascular/COPD comorbidity, fever, and elevated AST, potassium, and CRP.
  • The ABO locus risk variant (rs529565-C) was associated with rapid CXR deterioration.

Conclusions:

  • Rapidly worsening CXR findings during early hospitalization are a significant poor prognostic factor in COVID-19.
  • Clinical and genetic factors contribute to the risk of CXR deterioration.
  • Identifying these factors aids in predicting severe COVID-19 progression.

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