utility of early chest computed tomography to assess covid-19 prognosis: a retrospective cohort of 166 hospitalized patients in southern iran

Background: chest computed tomography (ct)-derived findings pose clinical value in detecting high-risk covid-19 patients. objectives: this retrospective cohort study aimed to assess poor hospital prognosis in covid-19 patients using on-admission chest ct findings. methods: this study included 166 hospitalized covid-19 patients with a confirmed diagnosis of covid-19 from october to december 2020 in southern iran. demographic variables, on-admission clinical and laboratory data, and on-admission high-resolution chest ct (hrct) such as visual lung involvement score, distribution, area, main pattern, and related features, as well as short-term follow-up during the hospital stay, were extracted. poor prognosis was defined as icu admission, need for invasive mechanical ventilation, development of acute respiratory distress syndrome, or death. results: the covid-19 patients with poor prognosis had a significantly higher visual lung involvement score compared to those without poor prognosis (20 [iqr: 14, 23] vs. 13 [iqr: 10, 17]; p < 0.0001). the two groups were not statistically different for other hrct findings. in a multivariable model, lung involvement score was the only statistically significant independent variable for in-patient covid-19 poor prognosis (odds ratio: 1.197 [95% confidence interval: 1.064, 1.348]; p = 0.003). conclusions: on-admission chest ct findings can potentially be utilized to evaluate prognosis and guide the treatment strategy of hospitalized covid-19 patients as early as during the emergency ward stay.