COVID-19 pneumonia: Perfusion abnormalities shown on subtraction CT angiography in apparently well-ventilated lungs. A prospective cohort study

Vista sencilla de ítem
dc.contributor.authorSantamarina, Mario G.
dc.contributor.authorLomakin, Felipe Martinez
dc.contributor.authorBeddings, Ignacio
dc.contributor.authorRiscal, Dominique Boisier
dc.contributor.authorChang Villacís, Jose
dc.contributor.authorContreras, Roberto
dc.contributor.authorMarambio, Jaime Vidal
dc.contributor.authorLabarca, Eduardo
dc.contributor.authorTorres, Jorge
dc.contributor.authorVolpacchio, Mariano
dc.date.accessioned2023-08-23T18:46:05Z
dc.date.available2023-08-23T18:46:05Z
dc.date.issued2023-07
dc.descriptionIndexación: Scopuses
dc.description.abstractPurpose: To evaluate whether a subtraction CT angiography (sCTA) perfusion score may have prognostic value in patients with COVID-19 pneumonia. Method: This prospective cohort study included adult patients with RT-PCR-confirmed SARS-CoV-2 infection admitted to the ED and a sCTA performed within 24 h of admission between June and September 2020. Perfusion abnormalities (PA) in areas of apparently spared lung parenchyma on conventional CT images were assessed with sCTA perfusion score. Airspace disease extension was assessed with CT severity scores, which were then correlated with clinical outcomes (admission to ICU, requirement of IMV, and death). Inter-rater reliability (IRR) was assessed using Cohen's Kappa. Independent predictors of adverse outcomes were evaluated by multivariable logistic regression analyses using the Hosmer and Lemeshow's test. Results: 191 patients were included: 112 males (58%), median age of 60.8 years (SD ± 16.0). The IRR was very high (median Kappa statistic: 0.95). No association was found between perfusion CT scores and D-dimer levels (Kendall's Tau-B coefficient = 0.08, p = 0.16) or between PaO2/FiO2 ratios and D-dimer levels (Kendall's Tau-B coefficient = −0.10, p = 0.07). Multivariate analyses adjusting for parenchymal disease extension, vascular beaded appearance, pulmonary embolism, sex, and age showed that severe PA remained a significant predictor for ICU admission (AOR: 6.25, 95% CI 2.10–18.7, p = 0.001). The overall diagnostic capacity of this model was adequate (ROC AUC: 0.83; 95% CI 0.77–0.89). Conclusions: The assessment of pulmonary perfusion abnormalities in areas of apparently spared lung parenchyma on conventional CT images via sCTA perfusion scoring has prognostic value in COVID-19 pneumonia. © 2023es
dc.identifier.citationHeliyon Volume 9, Issue 7July 2023 Article number e18085es
dc.identifier.doi10.1016/j.heliyon.2023.e18085
dc.identifier.issn2405-8440
dc.identifier.urihttps://repositorio.unab.cl/xmlui/handle/ria/52754
dc.language.isoenes
dc.publisherElsevier Ltdes
dc.rights.licenseAttribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectAngiotensin converting enzyme 2es
dc.subjectComputed tomography angiographyes
dc.subjectCOVID-19es
dc.subjectVasoconstrictiones
dc.subjectVentilation-perfusion ratioes
dc.titleCOVID-19 pneumonia: Perfusion abnormalities shown on subtraction CT angiography in apparently well-ventilated lungs. A prospective cohort studyes
dc.typeArtículoes
Archivos
Bloque original
Mostrando 1 - 1 de 1
Miniatura
Nombre:
PIIS2405844023052933.pdf
Tamaño:
4.19 MB
Formato:
Adobe Portable Document Format
Descripción:
TEXTO COMPLETO EN INGLÉS
Descargar
Bloque de licencias
Mostrando 1 - 1 de 1
No hay miniatura disponible
Nombre:
license.txt
Tamaño:
1.71 KB
Formato:
Item-specific license agreed upon to submission
Descripción:
Descargar
Colecciones
FM - Artículos de Revista