根据胸部CT扫描肺部病变程度分析重症Covid-19的临床、生物学、影像学及预后特征

Hervéat Ramanandafy
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摘要

简介:由SARSCov-2引起的新冠肺炎可能是严重和致命的。目的是根据胸部CT扫描肺部病变的程度,确定重症新冠肺炎的临床、生物学、CT和预后的相关性。患者和方法:这是一项回顾性分析研究,于2021年3月至5月在马达加斯加塔那那利佛Joseph Raseta Befelatanana大学医院呼吸科进行,为期三个月。结果:78例新冠肺炎重症病例符合入选标准,发病率为66.7%,患者平均年龄为52.81±16.64岁。三个CT扩展组的年龄没有差异(p=0.60)。男性、呼吸困难、C-反应蛋白升高与肺损伤程度相关(p<0.05)。在CT扫描上,磨玻璃图像和双侧受累也与肺部病变的CT扩展相关(p=0.03,p=0.04)。疾病超过26%的重症新冠肺炎患者的死亡率预后较差。结论:男性、呼吸困难、C反应蛋白、磨砂玻璃、新冠肺炎重症患者双侧影像等因素与肺部病变的CT程度相关。他们的理解将有可能在CT扫描上预测这些病变的不利演变,从而降低死亡率。
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Clinical, Biological, Scannographic and Prognosis Characteristics of Severe Covid-19 According To the Extent of Lung Lesions on Chest CT Scan
Introduction: COVID-19 caused by SARSCov-2 could be serious and fatal. The objective was to determine the correlation of clinical, biological, CT and prognosis of severe COVID-19 according to the extent of lung lesions on the chest CT scan. Patients and method: This is a retrospective analytical study carried out in the department of pneumology University Hospital of the Joseph Raseta Befelatanana, Antananarivo, Madagascar for a three-month period from March to May 2021. Results: 78 severe COVID-19 cases met the inclusion criteria, for an incidence of 66.7%. The mean age of our patients was 52.81 ± 16.64 years. Age did not differ for the three CT extension groups (p = 0.60). Male gender, dyspnea, C-Reactive protein elevation correlated with the extent of lung damage (p <0.05). On CT scan, the ground glass image and bilateral involvement were also associated with CT extension of lung lesions (p = 0.03, p = 0.04). The prognosis in terms of mortality was worse in severe COVID-19 patients with disease greater than 26%. The overall death was 6.41%. Conclusion: Factors such as male gender, dyspnea, C-reactive protein, frosted glass and bilateral images of severe COVID-19 patients were correlated with the CT extent of lung lesions. Their understandings would make it possible to predict the unfavorable evolution of these lesions on a CT scan, thus reducing mortality.
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