Are presentations of thoracic CT performed on admission to the ICU associated with mortality at day-90 in COVID-19 related ARDS?
Abstract Background Computed tomography (CT) analysis of lung morphology has significantly advanced our understanding of acute respiratory distress syndrome (ARDS). During the Coronavirus Disease 2019 (COVID-19) pandemic, CT imaging was widely utilized to evaluate lung injury and was suggested as a...
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BMC
2025-06-01
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| Series: | Pneumonia |
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| Online Access: | https://doi.org/10.1186/s41479-025-00166-y |
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| author | Alexia Le Corre Adel Maamar Mathieu Lederlin Nicolas Terzi Jean-Marc Tadié Arnaud Gacouin |
| author_facet | Alexia Le Corre Adel Maamar Mathieu Lederlin Nicolas Terzi Jean-Marc Tadié Arnaud Gacouin |
| author_sort | Alexia Le Corre |
| collection | DOAJ |
| description | Abstract Background Computed tomography (CT) analysis of lung morphology has significantly advanced our understanding of acute respiratory distress syndrome (ARDS). During the Coronavirus Disease 2019 (COVID-19) pandemic, CT imaging was widely utilized to evaluate lung injury and was suggested as a tool for predicting patient outcomes. However, data specifically focused on patients with ARDS admitted to intensive care units (ICUs) remain limited. Methods This retrospective study analyzed patients admitted to ICUs between March 2020 and November 2022 with moderate to severe COVID-19 ARDS. All CT scans performed within 48 h of ICU admission were independently reviewed by three experts. Lung injury severity was quantified using the CT Severity Score (CT-SS; range 0–25). Patients were categorized as having severe disease (CT-SS ≥ 18) or non-severe disease (CT-SS < 18). The primary outcome was all-cause mortality at 90 days. Secondary outcomes included ICU mortality and medical complications during the ICU stay. Additionally, we evaluated a computer-assisted CT-score assessment using artificial intelligence software (CT Pneumonia Analysis®, SIEMENS Healthcare) to explore the feasibility of automated measurement and routine implementation. Results A total of 215 patients with moderate to severe COVID-19 ARDS were included. The median CT-SS at admission was 18/25 [interquartile range, 15–21]. Among them, 120 patients (56%) had a severe CT-SS (≥ 18), while 95 patients (44%) had a non-severe CT-SS (< 18). The 90-day mortality rates were 20.8% for the severe group and 15.8% for the non-severe group (p = 0.35). No significant association was observed between CT-SS severity and patient outcomes. Conclusion In patients with moderate to severe COVID-19 ARDS, systematic CT assessment of lung parenchymal injury was not a reliable predictor of 90-day mortality or ICU-related complications. |
| format | Article |
| id | doaj-art-7652dbcb725d4dc580edeff5e6d5934f |
| institution | Kabale University |
| issn | 2200-6133 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Pneumonia |
| spelling | doaj-art-7652dbcb725d4dc580edeff5e6d5934f2025-08-20T03:25:19ZengBMCPneumonia2200-61332025-06-011711910.1186/s41479-025-00166-yAre presentations of thoracic CT performed on admission to the ICU associated with mortality at day-90 in COVID-19 related ARDS?Alexia Le Corre0Adel Maamar1Mathieu Lederlin2Nicolas Terzi3Jean-Marc Tadié4Arnaud Gacouin5CHU Rennes, Service de Maladies Infectieuses et Réanimation Médicale, Hôpital Pontchaillou, Université de Rennes 1CHU Rennes, Service de Maladies Infectieuses et Réanimation Médicale, Hôpital Pontchaillou, Université de Rennes 1Service de radiologie, Hôpital Pontchaillou, Université de RennesCHU Rennes, Service de Maladies Infectieuses et Réanimation Médicale, Hôpital Pontchaillou, Université de Rennes 1CHU Rennes, Service de Maladies Infectieuses et Réanimation Médicale, Hôpital Pontchaillou, Université de Rennes 1CHU Rennes, Service de Maladies Infectieuses et Réanimation Médicale, Hôpital Pontchaillou, Université de Rennes 1Abstract Background Computed tomography (CT) analysis of lung morphology has significantly advanced our understanding of acute respiratory distress syndrome (ARDS). During the Coronavirus Disease 2019 (COVID-19) pandemic, CT imaging was widely utilized to evaluate lung injury and was suggested as a tool for predicting patient outcomes. However, data specifically focused on patients with ARDS admitted to intensive care units (ICUs) remain limited. Methods This retrospective study analyzed patients admitted to ICUs between March 2020 and November 2022 with moderate to severe COVID-19 ARDS. All CT scans performed within 48 h of ICU admission were independently reviewed by three experts. Lung injury severity was quantified using the CT Severity Score (CT-SS; range 0–25). Patients were categorized as having severe disease (CT-SS ≥ 18) or non-severe disease (CT-SS < 18). The primary outcome was all-cause mortality at 90 days. Secondary outcomes included ICU mortality and medical complications during the ICU stay. Additionally, we evaluated a computer-assisted CT-score assessment using artificial intelligence software (CT Pneumonia Analysis®, SIEMENS Healthcare) to explore the feasibility of automated measurement and routine implementation. Results A total of 215 patients with moderate to severe COVID-19 ARDS were included. The median CT-SS at admission was 18/25 [interquartile range, 15–21]. Among them, 120 patients (56%) had a severe CT-SS (≥ 18), while 95 patients (44%) had a non-severe CT-SS (< 18). The 90-day mortality rates were 20.8% for the severe group and 15.8% for the non-severe group (p = 0.35). No significant association was observed between CT-SS severity and patient outcomes. Conclusion In patients with moderate to severe COVID-19 ARDS, systematic CT assessment of lung parenchymal injury was not a reliable predictor of 90-day mortality or ICU-related complications.https://doi.org/10.1186/s41479-025-00166-yAcute respiratory distress syndromeCOVID-19Computed tomographyCTMortality |
| spellingShingle | Alexia Le Corre Adel Maamar Mathieu Lederlin Nicolas Terzi Jean-Marc Tadié Arnaud Gacouin Are presentations of thoracic CT performed on admission to the ICU associated with mortality at day-90 in COVID-19 related ARDS? Pneumonia Acute respiratory distress syndrome COVID-19 Computed tomography CT Mortality |
| title | Are presentations of thoracic CT performed on admission to the ICU associated with mortality at day-90 in COVID-19 related ARDS? |
| title_full | Are presentations of thoracic CT performed on admission to the ICU associated with mortality at day-90 in COVID-19 related ARDS? |
| title_fullStr | Are presentations of thoracic CT performed on admission to the ICU associated with mortality at day-90 in COVID-19 related ARDS? |
| title_full_unstemmed | Are presentations of thoracic CT performed on admission to the ICU associated with mortality at day-90 in COVID-19 related ARDS? |
| title_short | Are presentations of thoracic CT performed on admission to the ICU associated with mortality at day-90 in COVID-19 related ARDS? |
| title_sort | are presentations of thoracic ct performed on admission to the icu associated with mortality at day 90 in covid 19 related ards |
| topic | Acute respiratory distress syndrome COVID-19 Computed tomography CT Mortality |
| url | https://doi.org/10.1186/s41479-025-00166-y |
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