Publication:
Early radiological worsening of SARS‑CoV‑2 pneumonia predicts the need for ventilatory support

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dc.contributor.authorPlasencia‑Martínez, Juana María
dc.contributor.authorCarrillo‑Alcaraz, Andrés
dc.contributor.authorMartín Cascón, Miguel
dc.contributor.authorPérez‑Costa, Rafael
dc.contributor.authorBallesta Ruiz, Mónica
dc.contributor.authorBlanco‑Barrio, Ana
dc.contributor.authorHerves‑Escobedo, Ignacio
dc.contributor.authorGómez‑Verdú, José‑Miguel
dc.contributor.authorAlcaraz‑Martínez, Julián
dc.contributor.authorAlemán‑Belando, Sergio
dc.contributor.authorCarrillo‑Burgos, María José
dc.contributor.departmentCiencias Sociosanitarias
dc.contributor.otherFacultad de Enfermería
dc.date.accessioned2026-02-26T17:14:52Z
dc.date.available2026-02-26T17:14:52Z
dc.date.copyright© 2021, The Author(s), under exclusive licence to European Society of Radiology
dc.date.issued2022-01-16
dc.description.abstractObjectives: Identifying early markers of poor prognosis of coronavirus disease 2019 (COVID-19) is mandatory. Our purpose is to analyze by chest radiography if rapid worsening of COVID-19 pneumonia in the initial days has predictive value for ventilatory support (VS) need. Methods: Ambispective observational ethically approved study in COVID-19 pneumonia inpatients, validated in a second outpatient sample. Brixia score (BS) was applied to the first and second chest radiography required for suspected COVID-19 pneumonia to determine the predictive capacity of BS worsening for VS need. Intraclass correlation coefficient (ICC) was previously analyzed among three radiologists. Sensitivity, specificity, likelihood ratios, AUC, and odds ratio were calculated using ROC curves and binary logistic regression analysis. A value of p < .05 was considered statistically significant. Results: A total of 120 inpatients (55 ± 14 years, 68 men) and 112 outpatients (56 ± 13 years, 61 men) were recruited. The average ICC of the BS was between 0.812 (95% confidence interval 0.745–0.878) and 0.906 (95% confidence interval 0.844–0.940). According to the multivariate analysis, a BS worsening per day > 1.3 points within 10 days of the onset of symptoms doubles the risk for requiring VS in inpatients and 5 times in outpatients (p < .001). The findings from the second chest radiography were always better predictors of VS requirement than those from the first one. Conclusion: The early radiological worsening of SARS-CoV-2 pneumonia after symptoms onset is a determining factor of the final prognosis. In elderly patients with some comorbidity and pneumonia, a 48–72-h follow-up radiograph is recommended.
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dc.format.extent11
dc.identifier.citationEur Radiol 32, 3490–3500 (2022)
dc.identifier.doihttps://doi.org/10.1007/s00330-021-08418-3
dc.identifier.eissn1432-1084
dc.identifier.issn0938-7994
dc.identifier.urihttp://hdl.handle.net/10201/215101
dc.languageeng
dc.publisherSpringer
dc.relationsin financiación externa a la Universidad
dc.relation.publisherversionhttps://link.springer.com/article/10.1007/s00330-021-08418-3
dc.rights.accessRightsinfo:eu-repo/semantics/restrictedAccess
dc.subjectRadiography
dc.subjectPrognosis
dc.subjectMechanical ventilation
dc.subjectBrixia score
dc.subjectCOVID-19
dc.subject.odsNo relacionado con ningún objetivo de desarrollo sostenible
dc.titleEarly radiological worsening of SARS‑CoV‑2 pneumonia predicts the need for ventilatory support
dc.typeinfo:eu-repo/semantics/article
dc.type.versioninfo:eu-repo/semantics/acceptedVersion
dspace.entity.typePublicationes
relation.isAuthorOfPublication40da91bd-38f8-47a5-a6d7-ce096b3e2c62
relation.isAuthorOfPublicationdbc036f9-e429-4373-a198-0082097acf67
relation.isAuthorOfPublication.latestForDiscovery40da91bd-38f8-47a5-a6d7-ce096b3e2c62
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