Lung Volume Measurement Using Chest CT in COVID-19 Patients: a Cohort Study in Japan

Overview

Journal BMJ Open Respir Res

Date 2024 Apr 25

PMID 38663888

Authors

Shiro Otake

Yusuke Shiraishi

Shotaro Chubachi

Naoya Tanabe

Tomoki Maetani

Takanori Asakura

Ho Namkoong

Takashi Shimada

Shuhei Azekawa

Kensuke Nakagawara

Hiromu Tanaka

Takahiro Fukushima

Mayuko Watase

Hideki Terai

Mamoru Sasaki

Soichiro Ueda

Yukari Kato

Norihiro Harada

Shoji Suzuki

Shuichi Yoshida

Hiroki Tateno

Yoshitake Yamada

Masahiro Jinzaki

Toyohiro Hirai

Yukinori Okada

Ryuji Koike

Makoto Ishii

Naoki Hasegawa

Akinori Kimura

Seiya Imoto

Satoru Miyano

Seishi Ogawa

Takanori Kanai

Koichi Fukunaga

Affiliations

Soon will be listed here.

Abstract

Objective: This study aimed to investigate the utility of CT quantification of lung volume for predicting critical outcomes in COVID-19 patients.

Methods: This retrospective cohort study included 1200 hospitalised patients with COVID-19 from 4 hospitals. Lung fields were extracted using artificial intelligence-based segmentation, and the percentage of the predicted (%pred) total lung volume (TLC (%pred)) was calculated. The incidence of critical outcomes and posthospitalisation complications was compared between patients with low and high CT lung volumes classified based on the median percentage of predicted TLC (n=600 for each). Prognostic factors for residual lung volume loss were investigated in 208 patients with COVID-19 via a follow-up CT after 3 months.

Results: The incidence of critical outcomes was higher in the low TLC (%pred) group than in the high TLC (%pred) group (14.2% vs 3.3%, p<0.0001). Multivariable analysis of previously reported factors (age, sex, body mass index and comorbidities) demonstrated that CT-derived lung volume was significantly associated with critical outcomes. The low TLC (%pred) group exhibited a higher incidence of bacterial infection, heart failure, thromboembolism, liver dysfunction and renal dysfunction than the high TLC (%pred) group. TLC (%pred) at 3 months was similarly divided into two groups at the median (71.8%). Among patients with follow-up CT scans, lung volumes showed a recovery trend from the time of admission to 3 months but remained lower in critical cases at 3 months.

Conclusion: Lower CT lung volume was associated with critical outcomes, posthospitalisation complications and slower improvement of clinical conditions in COVID-19 patients.

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