Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Apr 25:2024:5520174.
doi: 10.1155/2024/5520174. eCollection 2024.

Interest of Chest CT to Assess the Prognosis of SARS-CoV-2 Pneumonia: An In-Hospital-Based Experience in Sub-Saharan Africa

Serge Emmanuel Obe-A-Ndzem Holenn  1   2   3 , Tacite Kpanya Mazoba  2   4 , Désiré Yaya Mukanga  1 , Tyna Bongosepe Zokere  1 , Djo Lungela  5 , Jean-Robert Makulo  6 , Steve Ahuka  7 , Angèle Tanzia Mbongo  2   4 , Antoine Aundu Molua  2   4
Affiliations

Interest of Chest CT to Assess the Prognosis of SARS-CoV-2 Pneumonia: An In-Hospital-Based Experience in Sub-Saharan Africa

Serge Emmanuel Obe-A-Ndzem Holenn et al. Pulm Med. .

Abstract

Methods: We included all patients with respiratory symptoms (dyspnea, fever, and cough) and/or respiratory failure admitted to the SOS Médecins de nuit SARL hospital, DR Congo, during the 2nd and 3rd waves of the COVID-19 pandemic. The diagnosis of COVID-19 was established based on RT-PCR anti-SARS-CoV-2 tests (G1 (RT-PCR positive) vs. G2 (RT-PCR negative)), and all patients had a chest CT on the day of admission. We retrieved the digital files of patients, precisely the clinical, biological, and chest CT parameters of the day of admission as well as the vital outcome (survival or death). Chest CT were read by a very high-definition console using Advantage Windows software and exported to the hospital network using the RadiAnt DICOM viewer. To determine the threshold for the percentage of lung lesions associated with all-cause mortality, we used ROC curves. Factors associated with death, including chest CT parameters, were investigated using logistic regression analysis.

Results: The study included 200 patients (average age 56.2 ± 15.2 years; 19% diabetics and 4.5% obese), and COVID-19 was confirmed among 56% of them (G1). Chest CT showed that ground glass (72.3 vs. 39.8%), crazy paving (69.6 vs. 17.0%), and consolidation (83.9 vs. 22.7%), with bilateral and peripheral locations (68.8 vs. 30.7%), were more frequent in G1 vs. G2 (p < 0.001). No case of pulmonary embolism and fibrosis had been documented. The lung lesions affecting 30% of the parenchyma were informative in predicting death (area under the ROC curve at 0.705, p = 0.017). In multivariate analysis, a percentage of lesions affecting 50% of the lung parenchyma increased the risk of dying by 7.194 (1.656-31.250).

Conclusion: The chest CT demonstrated certain characteristic lesions more frequently in patients in whom the diagnosis of COVID-19 was confirmed. The extent of lesions affecting at least half of the lung parenchyma from the first day of admission to hospital increases the risk of death by a factor of 7.

PubMed Disclaimer

Conflict of interest statement

The authors of this article have no conflict of interest in this work.

Figures

Figure 1
Figure 1
Chest CT lesions: (a) ground glass, (b) crazy paving, and (c) consolidation.
Figure 2
Figure 2
ROC curve sensitivity and specificity.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Bao C., Liu X., Zhang H., Li Y., Liu J. Coronavirus disease 2019 (COVID-19) CT findings: a systematic review and meta-analysis. Journal of the American College of Radiology . 2020;17(6):701–709. doi: 10.1016/j.jacr.2020.03.006. - DOI - PMC - PubMed
    1. Xu B., Xing Y., Peng J., et al. Chest CT for detecting COVID-19: a systematic review and meta-analysis of diagnostic accuracy. European Radiology . 2020;30(10):5720–5727. doi: 10.1007/s00330-020-06934-2. - DOI - PMC - PubMed
    1. Wang W., Xu Y., Gao R., et al. Detection of SARS-CoV-2 in different types of clinical specimens. JAMA . 2020;323(18, article e203786):1843–1844. doi: 10.1001/jama.2020.3786. - DOI - PMC - PubMed
    1. Li G., Chen X., Xu A. Profile of specific antibodies to the SARS-associated coronavirus. The New England Journal of Medicine . 2003;349(5):508–509. doi: 10.1056/NEJM200307313490520. - DOI - PubMed
    1. Makulo J.-R., Mandina M. N., Mbala P. K., et al. SARS-CoV2 infection in symptomatic patients: interest of serological tests and predictors of mortality. Experience of DR Congo. BMC Infectious Diseases . 2022;22(1):p. 21. doi: 10.1186/s12879-021-07003-9. - DOI - PMC - PubMed