COVID-19 in patients with cancer: Can baseline radiologic severity and early evolution predict clinical outcomes? Journal Article

Authors: Perez-Johnston, R.; Araujo-Filho, J.; McKenney, A. S.; Gangai, N.; Plodkowski, A. J.; Liu, C. C.; Sawan, P.; Taur, Y.; Morjaria, S. M.; Ginsberg, M. S.
Article Title: COVID-19 in patients with cancer: Can baseline radiologic severity and early evolution predict clinical outcomes?
Abstract: Objective To determine whether the degree of parenchymal involvement on chest radiograph (CXR) at the time of COVID-19 diagnosis and its early radiologic evolution can predict adverse events including hospitalization, intubation, and death in patients with cancer. Methods Retrospective study of 627 COVID-19-positive patients between March and April 2020, of which 248 had baseline CXR within 72 h of diagnosis and 64 patients had follow-up wihtin72 h. CXRs were classified as abnormal (i.e., radiologic findings suggestive of COVID-19 infection were noted), normal, or indeterminate. Baseline and follow-up severity scores were calculated based on lung regions in abnormal CXRs. Statistical analysis was performed to determine associations between abnormal CXR or severity score with adverse events. Results Of 248 patients (median age = 65) with a baseline CXR, 172/248 (69%) had an abnormal baseline study, which was associated with hospitalization (p < 0.001), intubation (p = 0.001), and death (p = 0.005). For patients with solid neoplasms, when adjusted for stage, it was associated with hospitalization (p = 0.0002), intubation (p = 0.019), and death (p = 0.03). The median baseline severity score was 3 (range = 1-10); the greater the score, the higher the likelihood of adverse outcome (p < 0.003 for all). A baseline severity score > 9 predicted > 50% probability of intubation and a score of >= 10 predicted > 50% of probability of death. The baseline severity score was not correlated with cancer-related treatment. Early radiologic progression was not correlated with hospitalization, intubation, or death. Conclusion The degree of parenchymal involvement on CXR within 72 h of COVID-19 diagnosis is associated with adverse outcomes in patients with cancer.
Keywords: neoplasms; hospitalization; ct; intubation; radiograph; covid-19
Journal Title: European Radiology
Volume: 32
Issue: 4
ISSN: 0938-7994
Publisher: Springer  
Date Published: 2022-04-01
Start Page: 2661
End Page: 2671
Language: English
ACCESSION: WOS:000712938800002
DOI: 10.1007/s00330-021-08341-7
PMCID: PMC8556839
PUBMED: 34718846
Notes: Article -- Source: Wos
Citation Impact
MSK Authors
  1. Michelle S Ginsberg
    220 Ginsberg
  2. Corinne Liu
    7 Liu
  3. Ying Taur
    142 Taur
  4. Natalie Gangai
    41 Gangai
  5. Peter Sawan
    20 Sawan