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. 2022 Jan 20;29(2):243–262. doi: 10.1007/s10140-021-02008-y

Table 1.

Pulmonary prognostic findings for ICU admission

Reference Author Year CT findings Prognostic value
[18] Meiler 2020

Significantly higher incidence in patients with a negative outcome (33/64):

- consolidation (88%)

- crazy paving (42%)

- geographic shape of opacification (55%)

- bronchial dilatation (27%)

- air bronchogram (82%)

- pleural effusion (30%)

- vessel enlargement (64%)

- bilateral involvement (100%)

- RML involvement (100%)

- extent of parenchymal opacifications > 66% of lung volume (39%)

Independent predictors of a negative outcome (mechanical ventilation, ICU admission, extracorporeal membrane oxygenation, death):

crazy paving – OR 8.9, extent of parenchymal

opacifications > 66% of lung volume – OR 6.04

OR– negative outcome: 3.39 – dyspnea

[19] Parry 2020

Significantly higher incidence in clinically unstable patients (20/89):

- consolidation (80%)

- crazy paving (70%)

- vessel enlargement (90%)

- air bronchogram (65%)

- peripheral and central distribution (85%)

- anteroposterior distribution (70%)

- bilateral involvement (95%)

- percentage of total lung involvement (median 39.1%)

Increased frequency of specific CT findings in clinically unstable patients (ICU admission or death) – indicators of poor short-term prognosis

Higher frequency in clinically unstable patients:

- older age (median age 63.6 vs. 44.6)

[20] Tabatabaei 2020

Significantly higher incidence in ICU patients (11/120):

- consolidation (82%)

- crazy paving (45%)

- air bronchogram (45%)

- peripheral and central involvement (82%)

- percentage of total lung involvement (median 36.52, combined with death group)

- pleural effusion (45%)

Increased frequency of specific CT findings in ICU patients – indicators of poor short-term prognosis
[21] Cau 2021

Significantly higher incidence in ICU patients (23/218):

- consolidation

- mixed lesions

- bilateral opacities

- extensive involvement (GGO + consolidations)

Higher frequency in ICU patients:

- male sex

- comorbidities (cancer)

- abnormal laboratory values: high CRP and LDH

- high risk of mortality

[22] Tekcan Sanli 2020

Significantly higher incidence in ICU patients (20/231):

- consolidation (65%)

- affected lobe number (median 5)

- affected lung parenchyma percentage (median 50%)

- total number of lesions (median 13.5)

- mediastinal lymphadenopathy (25%)

- pleural effusion (50%)

- pleural thickening (25%)

- air bronchogram (40%)

Higher risk of ICU admission with consolidations in RML/RUL/LUP, increased number of affected lober, and percentage of affected parenchymal involvement

Higher frequency in clinically unstable patients:

- older age (median age 65.0)

- comorbidities: diabetes (50%), hypertension (70%), COPD (30%)

- PaO2 < 93% or respiratory rate > 20 (90%)

- abnormal laboratory values: low lymphocyte count (80%), N/L ratio > 3 (68.4%), high CRP (89.5%), elevated D-dimer (93.3%)

[23] Liang 2020

Higher incidence in discharged severe patients (26/47):

- first week: GGOs (79.2%), consolidation (16.7%)

- second week: GGOs (45.5%), consolidation (15.2%), reticular pattern (6.1%), mixed pattern (33.3%)

- from the third week: GGOs (29%), consolidation (2%), reticular pattern (33%), mixed pattern (37%)

Higher incidence in death severe patients (21/47):

- first week: GGOs (90%), consolidation (10%)

- second week: GGOs (92%), consolidation (8%)

- from the third week: GGOs (73%), consolidations (27%)

Significantly higher frequency in non-survivors:

- older age (median 77 years)

- comorbidities (cerebrovascular disease, diabetes mellitus, and kidney disease)

- clinical syndromes (sepsis and septic shock)

- abnormal laboratory values: CRP, ALT, lymphocyte count, and O2 saturation

Significant difference in discharged and dead patients:

- CT pattern within the second week

- CT pattern within the third week

- CT distribution within the third week (100% diffuse in the death group)

[24] Erturk 2020

Significantly higher incidence in ICU patients (25/262):

- crazy paving (64%)

- air bronchogram (44%)

- bronchus distortion (68%)

- bronchiectasis (80%)

- air trapping (52%)

- pleural thickening (60%)

- mediastinal/hilar lymph nodes enlargement (52%)

- number of involved lobes (median 5)

Increased frequency of specific CT findings in ICU patients – indicators of poor short-term prognosis

Higher frequency in ICU patients:

- older age (median age 64.56 vs. 53.89)

[25] Aydemire 2021

Significantly higher incidence in ICU patients (47/477):

- presence of lesions (96%)

- extension of lung involvement (4% – group 0, 19% – group 1, 26% – group 2, 51% – group 3)

Correlation between the extent of radiographic involvement and ICU admission

Correlation with increased lung involvement:

- abnormal laboratory values: increased D-dimer/Ferritin/LDH/CRP/ESR/ALT and decreased lymphocyte count

[26] Jin 2020

Significantly higher incidence in patients with adverse outcomes (13/94):

- diffuse lesions distribution in the entire lungs

- consolidation mixed with or without GGO

Independent risk factor for adverse outcome:

pattern 4– diffuse alveolar damage – HR 18.90

Correlation with adverse outcomes:

- age ≥ 65 years – HR 9.39

- comorbidity – HR 4.14

- severe or critical illness – HR 4.62

- presence of fatigue – HR 3.62, chest congestion and/or shortness of breath – HR 3.81 – abnormal laboratory value: neutrophil percentage > 75% – HR 14.12

[27] Chon 2020

Significantly higher incidence in severe patients (36/281):

- mixed consolidations and GGO (50%)

- crazy paving appearance(38.9%)

- pleural effusion (27.8%)

- similar lower and upper lobe distribution (22.2%)

- peripheral predominant distribution (72.2%)

- higher number of lobe involvement (median 3.5) and segment involvement(median 8)

Independent risk factor for critical events: pleural effusion – OR 19.41, crazy-paving appearance – OR 7.15

Correlation with critical events:

- age > 77 years – OR 16.26

- comorbidities: neurologic disease – OR 11.18, malignancy – OR 8.41

- abnormal laboratory value: absolute lymphocyte count, < 1320 cells/μL – OR 4.19, CRP > 0.5 mg/dL – OR 19.69, LDH > 474 U/L OR 5.05

[28] Abkhoo 2021

Higher incidence in ICU patients (121/121):

- GGOs (71.9%)

- peripheral (38.8%) and bilateral (98.3%) distribution

- lower lobe predominance (94.2%)

- cardiomegaly (63.6%)

- parenchymal bands (47.9%)

- crazy-paving pattern (44.4%)

Significantly higher frequency in non-survivors:

- pleural and pericardial effusion

- older age

- lower O2 saturation

- hypertension, low diastolic blood pressure

Predictive model (pericardial effusion – OR 6.56, SpO2 – OR 0.91, hypertension – OR 4.11) – mortality: sensitivity 78.7%, specificity 61.1%, PPV 90.0%, accuracy 75.5%

[29] Tekcan Sanli 2021

Correlation with the presence of specific vascular changes:

- lesions diameter > 5 cm

- crazy-paving pattern

- peripheral and central involvement

- higher risk of RML and LUL involvement

- involvement of > 2 lobes

- involvement of > 50% of lung parenchyma

Increased frequency of vascular changes in ICU patients – indicators of poor short-term prognosis

Correlation with the presence of specific vascular changes:

- PaO2 < 93% or respiratory rate > 20

- smoking rate – OR: 3.5

- abnormal laboratory values: increased CRP (median 5.7 mg/L) and LDH

[30] Hejazi 2021 Higher incidence in ICU patients (168/168): multifocal (58%) and bilateral (60%) GGO

Significant correlation in ICU patients:

- multifocal GGO and SOFA score on day 1

- bilateral GGO and SOFA score on day 1

- multifocal bilateral GGO and SOFA score on day 1

- multifocal bilateral GGO and SOFA score on day 5

- unilateral/bilateral GGO and CRP

- unifocal/unilateral/bilateral GGO patterns and overweight/obesity

- multifocal/bilateral GGO and heart failure

- unifocal/multifocal/unilateral/bilateral or multifocal bilateral GGO and cardiovascular diseases

- unifocal/unilateral GGO and malignancy