Well-aerated Lung on Admitting Chest CT to Predict Adverse Outcome in COVID-19 Pneumonia

2020

Conclusions

Both visual and quantitative measures of “well-aerated lung parenchyma” (WAL) — a biomarker of normal lung tissue — on admission chest CT scans were predictors of ICU (intensive care unit) admission or death in patients with COVID-19 pneumonia. From the study:

  • “Patients with coronavirus disease 2019 pneumonia at baseline chest CT who were admitted to the intensive care unit (ICU) or who died had four or more lobes of the lung affected compared with patients who were not admitted to the ICU or who did not die (94% vs 84% of patients, P , .04).
  • After adjustment for patient demographics and clinical parameters, visually assessed well-aerated lung parenchyma at admission on chest CT scans less than 73% was associated with ICU admission or death (odds ratio, 5.4; P , .001); software methods for lung quantification showed similar results.

Significance

Providers may benefit from VIDA’s automated measure of normal tissue when assessing COVID-19 patients for risk of progression.

  • Normal (WAL)
    • <71% is associated with 3.8x more risk of ICU/death​
    • <2.9L is associated with 2.6x more risk of ICU/death​
  • Typical COVID-19 pneumonia CT pattern​
    • Combo GGOs and consolidations​
    • Lower lobe predominant​
    • Diffuse distribution in axial plane​
  • ICU/death occurred more in patients with​
    • 4 or more lobes affected​
    • Emphysema present on CT​

VIDA Insights provides the following data related to this study:

  • VIDA Insights: Density Module
    • Normal density % = WAL (well aerated lung)
    • Measured -950HU to -700HU
    • Normal volume = VOL-WAL
    • LAA identified possible emphysema
    • Identifies which lobes are affected by abnormal density (LAA and/or HAA)
  • VIDA Insights: Texture Module
    • Breaks down texture features (GGO, consolidation, honeycombing)
    • Identifies which lobes are affected
    • Identifies texture patterns
texture analysis lung ILD

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