Association of Radiologic Findings With Mortality of Patients Infected With 2019 Novel Coronavirus in Wuhan, China

PLoS One. 2020 Mar 19;15(3):e0230548. doi: 10.1371/journal.pone.0230548. eCollection 2020.

Abstract

Radiologic characteristics of 2019 novel coronavirus (2019-nCoV) infected pneumonia (NCIP) which had not been fully understood are especially important for diagnosing and predicting prognosis. We retrospective studied 27 consecutive patients who were confirmed NCIP, the clinical characteristics and CT image findings were collected, and the association of radiologic findings with mortality of patients was evaluated. 27 patients included 12 men and 15 women, with median age of 60 years (IQR 47-69). 17 patients discharged in recovered condition and 10 patients died in hospital. The median age of mortality group was higher compared to survival group (68 (IQR 63-73) vs 55 (IQR 35-60), P = 0.003). The comorbidity rate in mortality group was significantly higher than in survival group (80% vs 29%, P = 0.018). The predominant CT characteristics consisted of ground glass opacity (67%), bilateral sides involved (86%), both peripheral and central distribution (74%), and lower zone involvement (96%). The median CT score of mortality group was higher compared to survival group (30 (IQR 7-13) vs 12 (IQR 11-43), P = 0.021), with more frequency of consolidation (40% vs 6%, P = 0.047) and air bronchogram (60% vs 12%, P = 0.025). An optimal cutoff value of a CT score of 24.5 had a sensitivity of 85.6% and a specificity of 84.5% for the prediction of mortality. 2019-nCoV was more likely to infect elderly people with chronic comorbidities. CT findings of NCIP were featured by predominant ground glass opacities mixed with consolidations, mainly peripheral or combined peripheral and central distributions, bilateral and lower lung zones being mostly involved. A simple CT scoring method was capable to predict mortality.

MeSH terms

  • Aged
  • China
  • Comorbidity
  • Coronavirus Infections / diagnostic imaging*
  • Coronavirus Infections / mortality*
  • Coronavirus Infections / pathology
  • Female
  • Humans
  • Lung / diagnostic imaging*
  • Lung / pathology
  • Male
  • Middle Aged
  • Pneumonia, Viral / diagnostic imaging*
  • Pneumonia, Viral / mortality*
  • Pneumonia, Viral / pathology
  • Predictive Value of Tests
  • Prognosis
  • ROC Curve
  • Retrospective Studies
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed

Supplementary concepts

  • COVID-19

Grant support

The authors received no specific funding for this work.