Prevalence and risk factors for lung involvement on low-dose chest CT (LDCT) in a paucisymptomatic population of 247 patients affected by COVID-19

Maxime Castelli (1) , Arnaud Maurin (1) , Axel Bartoli (1, 2) , Michael Dassa (1) , Baptiste Marchi (1) , Julie Finance (3) , Jean-Christophe J.-C. Lagier (4, 3) , Matthieu Million (4, 3) , Philippe Parola (5, 3) , Philippe Brouqui (4, 3) , Didier Raoult (4, 3) , Sebastien Cortaredona (5, 3) , Alexis Jacquier (6, 1) , Jean-Yves Gaubert (1, 6, 7) , Paul Habert (8, 9, 7)

1 TIMONE - Hôpital de la Timone [CHU - APHM]
2 CEMEREM - Centre d'Exploration Métabolique par Résonance Magnétique [Hôpital de la Timone - APHM]
3 IHU Marseille - Institut Hospitalier Universitaire Méditerranée Infection
4 MEPHI - Microbes évolution phylogénie et infections
5 VITROME - Vecteurs - Infections tropicales et méditerranéennes
6 CRMBM - Centre de résonance magnétique biologique et médicale
7 CERIMED - Centre Européen de Recherche en Imagerie médicale
8 Département de Radiologie [Hôpital de la Timone - APHM]
9 LIIE - Laboratoire d'Imagerie Interventionnelle Expérimentale

Background Low-dose chest CT (LDCT) showed high sensitivity and ability to quantify lung involvement of COVID-19 pneumopathy. The aim of this study was to describe the prevalence and risk factors for lung involvement in 247 patients with a visual score and assess the prevalence of incidental findings. Methods For 12 days in March 2020, 250 patients with RT-PCR positive tests and who underwent LDCT were prospectively included. Clinical and imaging findings were recorded. The extent of lung involvement was quantified using a score ranging from 0 to 40. A logistic regression model was used to explore factors associated with a score >= 10. Results A total of 247 patients were analyzed; 138 (54%) showed lung involvement. The mean score was 4.5 +/- 6.5, and the mean score for patients with lung involvement was 8.1 +/- 6.8 [1-31]. The mean age was 43 +/- 15 years, with 121 males (48%) and 17 asymptomatic patients (7%). Multivariate analysis showed that age > 54 years (odds ratio 4.4[2.0-9.6] p < 0.001) and diabetes (4.7[1.0-22.1] p = 0.049) were risk factors for a score >= 10. Multivariate analysis including symptoms showed that only age > 54 years (4.1[1.7-10.0] p = 0.002) was a risk factor for a score >= 10. Rhinitis (0.3[0.1-0.7] p = 0.005) and anosmia (0.3[0.1-0.9] p = 0.043) were protective against lung involvement. Incidental imaging findings were found in 19% of patients, with a need for follow-up in 0.6%. Conclusion The prevalence of lung involvement was 54% in a predominantly paucisymptomatic population. Age >= 55 years and diabetes were risk factors for significant parenchymal lung involvement. Rhinitis and anosmia were protective against LDCT abnormalities.

Mots clés: COVID-19; Tomography; X-ray computed; Quantitative evaluation; Pneumonia

Domaines: Sciences du Vivant [q-bio]

Maxime Castelli, Arnaud Maurin, Axel Bartoli, Michael Dassa, Baptiste Marchi, et al.. Prevalence and risk factors for lung involvement on low-dose chest CT (LDCT) in a paucisymptomatic population of 247 patients affected by COVID-19. Insights into Imaging, 2020, 11 (1), ⟨10.1186/s13244-020-00939-7⟩. ⟨hal-03149249⟩