• Yvon Ruch, Charlotte Kaeuffer, Mickael Ohana, Aissam Labani, Thibaut Fabacher, Pascal Bilbault, Sabrina Kepka, Morgane Solis, Valentin Greigert, Nicolas Lefebvre, Yves Hansmann, and François Danion.
• Department of Infectious Disease, Strasbourg University Hospital, Strasbourg, France. Electronic address: yvon.ruch@chru-strasbourg.fr.
• Clin. Microbiol. Infect. 2020 Oct 1; 26 (10): 1417.e5-1417.e8.

ObjectiveThe main objective of this study was to investigate the prognostic value of early systematic chest computed tomography (CT) with quantification of lung lesions in coronavirus disease 2019 (COVID-19) patients.MethodsWe studied 572 patients diagnosed with COVID-19 (confirmed using polymerase chain reaction) for whom a chest CT was performed at hospital admission. Visual quantification was used to classify patients as per the percentage of lung parenchyma affected by COVID-19 lesions: normal CT, 0-10%, 11-25%, 26-50%, 51-75% and >75%. The primary endpoint was severe disease, defined by death or admission to the intensive care unit in the 7 days following first admission.ResultsThe mean patient age was 66.0 ± 16.0 years, and 343/572 (60.0%) were men. The primary endpoint occurred in 206/572 patients (36.0%). The extent of lesions on initial CT was independently associated with prognosis (odds ratio = 2.35, 95% confidence interval 1.24-4.46; p < 0.01). Most patients with lung involvement >50% (66/95, 69.5%) developed severe disease compared to patients with lung involvement of 26-50% (70/171, 40.9%) and ≤25% (70/306, 22.9%) (p < 0.01 and p < 0.01, respectively). None of the patients with normal CT (0/14) had severe disease.ConclusionChest CT findings at admission are associated with outcome in COVID-19 patients.Copyright © 2020 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

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