CT-derived Chest Muscle Metrics for Outcome Prediction in Patients with COVID-19

Simone Schiaffino; Domenico Albano; Andrea Cozzi; Carmelo Messina; Roberto Arioli; Claudio Bnà; Antonio Bruno; Luca A Carbonaro; Alessandro CARRIERO; Serena Carriero; Pietro S C Danna; Elisa D'Ascoli; Claudia De Berardinis; Gianmarco Della Pepa; Zeno Falaschi; Salvatore Gitto; Alexis E Malavazos; Giovanni Mauri; Lorenzo Monfardini; Alessio Paschè; Roberto Rizzati; Francesco Secchi; Angelo Vanzulli; Valeria Tombini; Ilaria Vicentin; Domenico Zagaria; Francesco Sardanelli; Luca M Sconfienza

doi:10.1148/radiol.2021204141

CT-derived Chest Muscle Metrics for Outcome Prediction in Patients with COVID-19

Simone Schiaffino, Domenico Albano, Andrea Cozzi, Carmelo Messina, Roberto Arioli, Claudio Bnà, Antonio Bruno, Luca A Carbonaro, Alessandro CARRIERO, Serena Carriero, Pietro S C Danna, Elisa D'Ascoli, Claudia De Berardinis, Gianmarco Della Pepa, Zeno Falaschi, Salvatore Gitto, Alexis E Malavazos, Giovanni Mauri, Lorenzo Monfardini, Alessio PaschèRoberto Rizzati, Francesco Secchi, Angelo Vanzulli, Valeria Tombini, Ilaria Vicentin, Domenico Zagaria, Francesco Sardanelli, Luca M Sconfienza

Dipartimento di Medicina Traslazionale

Risultato della ricerca: Contributo su rivista › Articolo in rivista › peer review

Abstract

Background Lower muscle mass is a known predictor of unfavorable outcome, but its prognostic impact on COVID-19 patients is unknown. Purpose To investigate the contribution of CT-derived muscle status in predicting clinical outcomes in COVID-19 patients. Materials and Methods Clinical/laboratory data and outcomes (intensive care unit [ICU] admission and death) were retrospectively retrieved for patients with reverse transcriptase polymerase chain reaction-confirmed COVID-19, who underwent chest CT on admission in four hospitals in Northern Italy from February 21 to April 30, 2020. Extent and type of pulmonary involvement, mediastinal lymphadenopathy, and pleural effusion were assessed. Cross-sectional areas and attenuation of paravertebral muscles were measured on axial CT images at T5 and T12 vertebral level. Multivariable linear and binary logistic regression, including calculation odds ratios (OR) with 95% confidence intervals (CIs), were used to build four models to predict ICU admission and death, tested and compared using receiver operating characteristic curve (ROC) analysis. Results A total 552 patients (364 men; median age 65 years, interquartile range 54-75) were included. In a CT-based model, lower-than-median T5 paravertebral muscle area showed the highest ORs for ICU admission (OR 4.8, 95% CI 2.7-8.5; P<.001) and death (OR 2.3, 95% CI 1.0-2.9; P=.027). When clinical variables were included in the model, lower-than-median T5 paravertebral muscle area still showed the highest ORs both for ICU admission (OR 4.3; 95% CI 2.5-7.7; P<.001) and death (OR 2.3, 95% CI 1.3-3.7; P=.001). At ROC analysis, the CT-based model and the model including clinical variables showed the same area under the curve (AUC) for ICU admission prediction (AUC 0.83, P=.380) and were not different in predicting death (AUC 0.86 versus AUC 0.87, respectively, P=.282). Conclusion In hospitalized patients with COVID-19, lower muscle mass on CT was independently associated with ICU admission and hospital mortality.

Lingua originale	Inglese
Rivista	Radiology
DOI	https://doi.org/10.1148/radiol.2021204141
Stato di pubblicazione	Pubblicato - 2021

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10.1148/radiol.2021204141

https://hdl.handle.net/11579/122568

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Schiaffino, S., Albano, D., Cozzi, A., Messina, C., Arioli, R., Bnà, C., Bruno, A., Carbonaro, L. A., CARRIERO, A., Carriero, S., Danna, P. S. C., D'Ascoli, E., De Berardinis, C., Della Pepa, G., Falaschi, Z., Gitto, S., Malavazos, A. E., Mauri, G., Monfardini, L., ... Sconfienza, L. M. (2021). CT-derived Chest Muscle Metrics for Outcome Prediction in Patients with COVID-19. Radiology. https://doi.org/10.1148/radiol.2021204141

@article{a9b3d1c469634772875cd51e8167743d,

title = "CT-derived Chest Muscle Metrics for Outcome Prediction in Patients with COVID-19",

abstract = "Background Lower muscle mass is a known predictor of unfavorable outcome, but its prognostic impact on COVID-19 patients is unknown. Purpose To investigate the contribution of CT-derived muscle status in predicting clinical outcomes in COVID-19 patients. Materials and Methods Clinical/laboratory data and outcomes (intensive care unit [ICU] admission and death) were retrospectively retrieved for patients with reverse transcriptase polymerase chain reaction-confirmed COVID-19, who underwent chest CT on admission in four hospitals in Northern Italy from February 21 to April 30, 2020. Extent and type of pulmonary involvement, mediastinal lymphadenopathy, and pleural effusion were assessed. Cross-sectional areas and attenuation of paravertebral muscles were measured on axial CT images at T5 and T12 vertebral level. Multivariable linear and binary logistic regression, including calculation odds ratios (OR) with 95% confidence intervals (CIs), were used to build four models to predict ICU admission and death, tested and compared using receiver operating characteristic curve (ROC) analysis. Results A total 552 patients (364 men; median age 65 years, interquartile range 54-75) were included. In a CT-based model, lower-than-median T5 paravertebral muscle area showed the highest ORs for ICU admission (OR 4.8, 95% CI 2.7-8.5; P<.001) and death (OR 2.3, 95% CI 1.0-2.9; P=.027). When clinical variables were included in the model, lower-than-median T5 paravertebral muscle area still showed the highest ORs both for ICU admission (OR 4.3; 95% CI 2.5-7.7; P<.001) and death (OR 2.3, 95% CI 1.3-3.7; P=.001). At ROC analysis, the CT-based model and the model including clinical variables showed the same area under the curve (AUC) for ICU admission prediction (AUC 0.83, P=.380) and were not different in predicting death (AUC 0.86 versus AUC 0.87, respectively, P=.282). Conclusion In hospitalized patients with COVID-19, lower muscle mass on CT was independently associated with ICU admission and hospital mortality.",

author = "Simone Schiaffino and Domenico Albano and Andrea Cozzi and Carmelo Messina and Roberto Arioli and Claudio Bn{\`a} and Antonio Bruno and Carbonaro, {Luca A} and Alessandro CARRIERO and Serena Carriero and Danna, {Pietro S C} and Elisa D'Ascoli and {De Berardinis}, Claudia and {Della Pepa}, Gianmarco and Zeno Falaschi and Salvatore Gitto and Malavazos, {Alexis E} and Giovanni Mauri and Lorenzo Monfardini and Alessio Pasch{\`e} and Roberto Rizzati and Francesco Secchi and Angelo Vanzulli and Valeria Tombini and Ilaria Vicentin and Domenico Zagaria and Francesco Sardanelli and Sconfienza, {Luca M}",

note = "Publisher Copyright: {\textcopyright} RSNA, 2021",

year = "2021",

doi = "10.1148/radiol.2021204141",

language = "English",

journal = "Radiology",

issn = "0033-8419",

publisher = "Radiological Society of North America Inc.",

}

Schiaffino, S, Albano, D, Cozzi, A, Messina, C, Arioli, R, Bnà, C, Bruno, A, Carbonaro, LA, CARRIERO, A, Carriero, S, Danna, PSC, D'Ascoli, E, De Berardinis, C, Della Pepa, G, Falaschi, Z, Gitto, S, Malavazos, AE, Mauri, G, Monfardini, L, Paschè, A, Rizzati, R, Secchi, F, Vanzulli, A, Tombini, V, Vicentin, I, Zagaria, D, Sardanelli, F & Sconfienza, LM 2021, 'CT-derived Chest Muscle Metrics for Outcome Prediction in Patients with COVID-19', Radiology. https://doi.org/10.1148/radiol.2021204141

TY - JOUR

T1 - CT-derived Chest Muscle Metrics for Outcome Prediction in Patients with COVID-19

AU - Schiaffino, Simone

AU - Albano, Domenico

AU - Cozzi, Andrea

AU - Messina, Carmelo

AU - Arioli, Roberto

AU - Bnà, Claudio

AU - Bruno, Antonio

AU - Carbonaro, Luca A

AU - CARRIERO, Alessandro

AU - Carriero, Serena

AU - Danna, Pietro S C

AU - D'Ascoli, Elisa

AU - De Berardinis, Claudia

AU - Della Pepa, Gianmarco

AU - Falaschi, Zeno

AU - Gitto, Salvatore

AU - Malavazos, Alexis E

AU - Mauri, Giovanni

AU - Monfardini, Lorenzo

AU - Paschè, Alessio

AU - Rizzati, Roberto

AU - Secchi, Francesco

AU - Vanzulli, Angelo

AU - Tombini, Valeria

AU - Vicentin, Ilaria

AU - Zagaria, Domenico

AU - Sardanelli, Francesco

AU - Sconfienza, Luca M

PY - 2021

Y1 - 2021

N2 - Background Lower muscle mass is a known predictor of unfavorable outcome, but its prognostic impact on COVID-19 patients is unknown. Purpose To investigate the contribution of CT-derived muscle status in predicting clinical outcomes in COVID-19 patients. Materials and Methods Clinical/laboratory data and outcomes (intensive care unit [ICU] admission and death) were retrospectively retrieved for patients with reverse transcriptase polymerase chain reaction-confirmed COVID-19, who underwent chest CT on admission in four hospitals in Northern Italy from February 21 to April 30, 2020. Extent and type of pulmonary involvement, mediastinal lymphadenopathy, and pleural effusion were assessed. Cross-sectional areas and attenuation of paravertebral muscles were measured on axial CT images at T5 and T12 vertebral level. Multivariable linear and binary logistic regression, including calculation odds ratios (OR) with 95% confidence intervals (CIs), were used to build four models to predict ICU admission and death, tested and compared using receiver operating characteristic curve (ROC) analysis. Results A total 552 patients (364 men; median age 65 years, interquartile range 54-75) were included. In a CT-based model, lower-than-median T5 paravertebral muscle area showed the highest ORs for ICU admission (OR 4.8, 95% CI 2.7-8.5; P<.001) and death (OR 2.3, 95% CI 1.0-2.9; P=.027). When clinical variables were included in the model, lower-than-median T5 paravertebral muscle area still showed the highest ORs both for ICU admission (OR 4.3; 95% CI 2.5-7.7; P<.001) and death (OR 2.3, 95% CI 1.3-3.7; P=.001). At ROC analysis, the CT-based model and the model including clinical variables showed the same area under the curve (AUC) for ICU admission prediction (AUC 0.83, P=.380) and were not different in predicting death (AUC 0.86 versus AUC 0.87, respectively, P=.282). Conclusion In hospitalized patients with COVID-19, lower muscle mass on CT was independently associated with ICU admission and hospital mortality.

AB - Background Lower muscle mass is a known predictor of unfavorable outcome, but its prognostic impact on COVID-19 patients is unknown. Purpose To investigate the contribution of CT-derived muscle status in predicting clinical outcomes in COVID-19 patients. Materials and Methods Clinical/laboratory data and outcomes (intensive care unit [ICU] admission and death) were retrospectively retrieved for patients with reverse transcriptase polymerase chain reaction-confirmed COVID-19, who underwent chest CT on admission in four hospitals in Northern Italy from February 21 to April 30, 2020. Extent and type of pulmonary involvement, mediastinal lymphadenopathy, and pleural effusion were assessed. Cross-sectional areas and attenuation of paravertebral muscles were measured on axial CT images at T5 and T12 vertebral level. Multivariable linear and binary logistic regression, including calculation odds ratios (OR) with 95% confidence intervals (CIs), were used to build four models to predict ICU admission and death, tested and compared using receiver operating characteristic curve (ROC) analysis. Results A total 552 patients (364 men; median age 65 years, interquartile range 54-75) were included. In a CT-based model, lower-than-median T5 paravertebral muscle area showed the highest ORs for ICU admission (OR 4.8, 95% CI 2.7-8.5; P<.001) and death (OR 2.3, 95% CI 1.0-2.9; P=.027). When clinical variables were included in the model, lower-than-median T5 paravertebral muscle area still showed the highest ORs both for ICU admission (OR 4.3; 95% CI 2.5-7.7; P<.001) and death (OR 2.3, 95% CI 1.3-3.7; P=.001). At ROC analysis, the CT-based model and the model including clinical variables showed the same area under the curve (AUC) for ICU admission prediction (AUC 0.83, P=.380) and were not different in predicting death (AUC 0.86 versus AUC 0.87, respectively, P=.282). Conclusion In hospitalized patients with COVID-19, lower muscle mass on CT was independently associated with ICU admission and hospital mortality.

UR - https://iris.uniupo.it/handle/11579/122568

U2 - 10.1148/radiol.2021204141

DO - 10.1148/radiol.2021204141

M3 - Article

SN - 0033-8419

JO - Radiology

JF - Radiology

ER -

CT-derived Chest Muscle Metrics for Outcome Prediction in Patients with COVID-19

Abstract

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