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Lung volume measurement using chest CT in COVID-19 patients: a cohort study in Japan.
- Source :
-
BMJ open respiratory research [BMJ Open Respir Res] 2024 Apr 24; Vol. 11 (1). Date of Electronic Publication: 2024 Apr 24. - Publication Year :
- 2024
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Abstract
- Objective: This study aimed to investigate the utility of CT quantification of lung volume for predicting critical outcomes in COVID-19 patients.<br />Methods: This retrospective cohort study included 1200 hospitalised patients with COVID-19 from 4 hospitals. Lung fields were extracted using artificial intelligence-based segmentation, and the percentage of the predicted (%pred) total lung volume (TLC (%pred)) was calculated. The incidence of critical outcomes and posthospitalisation complications was compared between patients with low and high CT lung volumes classified based on the median percentage of predicted TLC <subscript>ct</subscript> (n=600 for each). Prognostic factors for residual lung volume loss were investigated in 208 patients with COVID-19 via a follow-up CT after 3 months.<br />Results: The incidence of critical outcomes was higher in the low TLC <subscript>ct</subscript> (%pred) group than in the high TLC <subscript>ct</subscript> (%pred) group (14.2% vs 3.3%, p<0.0001). Multivariable analysis of previously reported factors (age, sex, body mass index and comorbidities) demonstrated that CT-derived lung volume was significantly associated with critical outcomes. The low TLC <subscript>ct</subscript> (%pred) group exhibited a higher incidence of bacterial infection, heart failure, thromboembolism, liver dysfunction and renal dysfunction than the high TLC <subscript>ct</subscript> (%pred) group. TLC <subscript>ct</subscript> (%pred) at 3 months was similarly divided into two groups at the median (71.8%). Among patients with follow-up CT scans, lung volumes showed a recovery trend from the time of admission to 3 months but remained lower in critical cases at 3 months.<br />Conclusion: Lower CT lung volume was associated with critical outcomes, posthospitalisation complications and slower improvement of clinical conditions in COVID-19 patients.<br />Competing Interests: Competing interests: None declared.<br /> (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Details
- Language :
- English
- ISSN :
- 2052-4439
- Volume :
- 11
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- BMJ open respiratory research
- Publication Type :
- Academic Journal
- Accession number :
- 38663888
- Full Text :
- https://doi.org/10.1136/bmjresp-2023-002234