Association between chest ct findings and prognosis in patients with SARS-CoV-2 pneumonia over a 4-week follow-up

Abstract

Introduction: The SARS-CoV-2 pandemic has caused millions of deaths, with SARS-CoV-2 pneumonia being a leading cause of acute respiratory infection. Our objective is to evaluate the association between chest CT findings and prognosis in patients hospitalized for this infection. Methods: We included 360 adult patients from a fourth level center, diagnosed with COVID-19 by RT-PCR, who had a chest CT scan at the beginning of their hospitalization. We assessed by means of logistic regression the relationship between imaging findings and survival. Results: The most frequent findings were ground glass pattern (87%), followed by consolidation (27%), cobblestone pattern (18%) and organizing pneumonia (6%). Most patients survived (77.5%), while 16.9% died within four weeks. The presence of alterations in the diagnostic imaging represented a tendency to be risk factors for death, finding that consolidation was associated with an increased risk of mortality by 10%. Discussion: The detection of alterations or semiological findings on chest CT is associated with worse prognosis within the first 4 weeks for SARS-CoV-2 infected patients. The results highlight that early identification of certain imaging findings could improve severity prediction and guide clinical decisions. Going forward, it is recommended to evaluate the chronological evolution of findings to optimize the management of patients with SARS-CoV-2 infection.