Clinical implication of radiographic scores in acute Middle East respiratory syndrome coronavirus pneumonia: Report from a single tertiary-referral center of South Korea
Identifieur interne : 000622 ( Pmc/Checkpoint ); précédent : 000621; suivant : 000623Clinical implication of radiographic scores in acute Middle East respiratory syndrome coronavirus pneumonia: Report from a single tertiary-referral center of South Korea
Auteurs : Min Jae Cha [Corée du Sud] ; Myung Jin Chung [Corée du Sud] ; Kyunga Kim [Corée du Sud] ; Kyung Soo Lee [Corée du Sud] ; Tae Jung Kim [Corée du Sud] ; Tae Sung Kim [Corée du Sud]Source :
- European Journal of Radiology [ 0720-048X ] ; 2018.
Abstract
Radiographic score can play a pivotal role for patients with MERS pneumonia. The cutoff radiographic (RG) score is 10 on 10th day from MERS-CoV exposure. Patients with RG score above the cutoff are prone to show respiratory distress. Patients with RG score above 10 on 10th day from viral exposure need aggressive care.
Url:
DOI: 10.1016/j.ejrad.2018.09.008
PubMed: 30292266
PubMed Central: 7127293
Affiliations:
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Clinical implication of radiographic scores in acute Middle East respiratory syndrome coronavirus pneumonia: Report from a single tertiary-referral center of South Korea</title>
<author><name sortKey="Cha, Min Jae" sort="Cha, Min Jae" uniqKey="Cha M" first="Min Jae" last="Cha">Min Jae Cha</name>
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<author><name sortKey="Kim, Tae Sung" sort="Kim, Tae Sung" uniqKey="Kim T" first="Tae Sung" last="Kim">Tae Sung Kim</name>
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<series><title level="j">European Journal of Radiology</title>
<idno type="ISSN">0720-048X</idno>
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<front><div type="abstract" xml:lang="en"><title>Highlights</title>
<p><list list-type="simple" id="lis0005"><list-item id="lsti0005"><label>•</label>
<p id="par0005">Radiographic score can play a pivotal role for patients with MERS pneumonia.</p>
</list-item>
<list-item id="lsti0010"><label>•</label>
<p id="par0010">The cutoff radiographic (RG) score is 10 on 10th day from MERS-CoV exposure.</p>
</list-item>
<list-item id="lsti0015"><label>•</label>
<p id="par0015">Patients with RG score above the cutoff are prone to show respiratory distress.</p>
</list-item>
<list-item id="lsti0020"><label>•</label>
<p id="par0020">Patients with RG score above 10 on 10<sup>th</sup>
day from viral exposure need aggressive care.</p>
</list-item>
</list>
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<front><journal-meta><journal-id journal-id-type="nlm-ta">Eur J Radiol</journal-id>
<journal-id journal-id-type="iso-abbrev">Eur J Radiol</journal-id>
<journal-title-group><journal-title>European Journal of Radiology</journal-title>
</journal-title-group>
<issn pub-type="ppub">0720-048X</issn>
<issn pub-type="epub">1872-7727</issn>
<publisher><publisher-name>Elsevier B.V.</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">30292266</article-id>
<article-id pub-id-type="pmc">7127293</article-id>
<article-id pub-id-type="publisher-id">S0720-048X(18)30314-0</article-id>
<article-id pub-id-type="doi">10.1016/j.ejrad.2018.09.008</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Clinical implication of radiographic scores in acute Middle East respiratory syndrome coronavirus pneumonia: Report from a single tertiary-referral center of South Korea</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" id="aut0005"><name><surname>Cha</surname>
<given-names>Min Jae</given-names>
</name>
<xref rid="aff0005" ref-type="aff">a</xref>
<xref rid="fn0005" ref-type="fn">1</xref>
</contrib>
<contrib contrib-type="author" id="aut0010"><name><surname>Chung</surname>
<given-names>Myung Jin</given-names>
</name>
<email>mj1.chung@samsung.com</email>
<xref rid="aff0005" ref-type="aff">a</xref>
<xref rid="cor0005" ref-type="corresp">⁎</xref>
</contrib>
<contrib contrib-type="author" id="aut0015"><name><surname>Kim</surname>
<given-names>Kyunga</given-names>
</name>
<xref rid="aff0010" ref-type="aff">b</xref>
<xref rid="aff0015" ref-type="aff">c</xref>
</contrib>
<contrib contrib-type="author" id="aut0020"><name><surname>Lee</surname>
<given-names>Kyung Soo</given-names>
</name>
<xref rid="aff0005" ref-type="aff">a</xref>
</contrib>
<contrib contrib-type="author" id="aut0025"><name><surname>Kim</surname>
<given-names>Tae Jung</given-names>
</name>
<xref rid="aff0005" ref-type="aff">a</xref>
</contrib>
<contrib contrib-type="author" id="aut0030"><name><surname>Kim</surname>
<given-names>Tae Sung</given-names>
</name>
<xref rid="aff0005" ref-type="aff">a</xref>
</contrib>
</contrib-group>
<aff id="aff0005"><label>a</label>
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea</aff>
<aff id="aff0010"><label>b</label>
Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul 06351, Republic of Korea</aff>
<aff id="aff0015"><label>c</label>
Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul 06351, Republic of Korea</aff>
<author-notes><corresp id="cor0005"><label>⁎</label>
Corresponding author at: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Ku, Seoul 06351, Republic of Korea. <email>mj1.chung@samsung.com</email>
</corresp>
<fn id="fn0005"><label>1</label>
<p id="npar0005">Current address: Department of Radiology, Chung-Ang university hospital, Chung-Ang University College of Medicine, Seoul 06973, Republic of Korea.</p>
</fn>
</author-notes>
<pub-date pub-type="pmc-release"><day>11</day>
<month>9</month>
<year>2018</year>
</pub-date>
<pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="ppub"><month>10</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub"><day>11</day>
<month>9</month>
<year>2018</year>
</pub-date>
<volume>107</volume>
<fpage>196</fpage>
<lpage>202</lpage>
<history><date date-type="received"><day>19</day>
<month>4</month>
<year>2018</year>
</date>
<date date-type="rev-recd"><day>12</day>
<month>7</month>
<year>2018</year>
</date>
<date date-type="accepted"><day>10</day>
<month>9</month>
<year>2018</year>
</date>
</history>
<permissions><copyright-statement>© 2018 Elsevier B.V. All rights reserved.</copyright-statement>
<copyright-year>2018</copyright-year>
<copyright-holder>Elsevier B.V.</copyright-holder>
<license><license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p>
</license>
</permissions>
<abstract abstract-type="author-highlights" id="abs0005"><title>Highlights</title>
<p><list list-type="simple" id="lis0005"><list-item id="lsti0005"><label>•</label>
<p id="par0005">Radiographic score can play a pivotal role for patients with MERS pneumonia.</p>
</list-item>
<list-item id="lsti0010"><label>•</label>
<p id="par0010">The cutoff radiographic (RG) score is 10 on 10th day from MERS-CoV exposure.</p>
</list-item>
<list-item id="lsti0015"><label>•</label>
<p id="par0015">Patients with RG score above the cutoff are prone to show respiratory distress.</p>
</list-item>
<list-item id="lsti0020"><label>•</label>
<p id="par0020">Patients with RG score above 10 on 10<sup>th</sup>
day from viral exposure need aggressive care.</p>
</list-item>
</list>
</p>
</abstract>
<abstract id="abs0010"><p>The aim of this study is to determine the earliest cutoff of radiographic score as a potential prognostic indicator of fatal outcomes in patients with acute Middle East respiratory syndrome coronavirus (MERS-CoV) pneumonia. The institutional review board approved this retrospective study. Serial chest radiographies (CXRs) were obtained from viral exposure until death or discharge in 35 patients with laboratory confirmed MERS-CoV infection. Radiographic scores were calculated by multiplying a four-point scale of involved lung area and three-point scale of abnormal opacification, in each of the six lung zones. Receiver operating characteristics (ROC) analyses were performed to identify optimal day and radiographic score for the prediction of respiratory distress, and univariate and multivariate logistic regression analyses were performed to assess significant predictive factors for intubation or tracheostomy. Among 35 patients (22 men, 13 women; median age: 48 years), 25 demonstrated abnormal opacity on CXR (MERS pneumonia), whereas no abnormality was detected in 10 patients (MERS upper respiratory tract infection). Seven patients required ventilator support (intubation group) and three of them eventually expired. The average incubation period was 5.4 days (standard deviation, ±2.8; range, 2–11). Patients in the intubation group had a higher incidence of diffuse lung involvement, higher radiographic scores, and fibrosing sequela on follow up study compared with those in the non-intubation group. However, patients’ age and comorbidity did not differ significantly between the two groups. The ROC analysis revealed an area under curve of 0.726 for the radiographic score on day 10 with an optimal cutoff score of 10 for prediction of intubation, with a sensitivity of 71% and specificity of 67%. Our study suggest that MERS patients with radiographic score > 10 on day 10 from viral exposure require aggressive therapy with careful surveillance and follow-up evaluation.</p>
</abstract>
<kwd-group id="kwd0005"><title>Abbreviations</title>
<kwd>MERS, Middle East respiratory syndrome</kwd>
<kwd>CoV, coronavirus</kwd>
<kwd>CXR, chest radiography</kwd>
<kwd>CT, computed tomography</kwd>
<kwd>ER, emergency room</kwd>
<kwd>ROC, receiver operating characteristic</kwd>
<kwd>URI, upper respiratory tract infection</kwd>
<kwd>AUC, area under the ROC curve</kwd>
</kwd-group>
<kwd-group id="kwd0010"><title>Keywords</title>
<kwd>Middle East respiratory syndrome coronavirus (MERS-CoV)</kwd>
<kwd>Chest radiographic score</kwd>
<kwd>Chest radiograph</kwd>
<kwd>Prognostic indicator</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>Corée du Sud</li>
</country>
<region><li>Région capitale de Séoul</li>
</region>
<settlement><li>Séoul</li>
</settlement>
</list>
<tree><country name="Corée du Sud"><region name="Région capitale de Séoul"><name sortKey="Cha, Min Jae" sort="Cha, Min Jae" uniqKey="Cha M" first="Min Jae" last="Cha">Min Jae Cha</name>
</region>
<name sortKey="Chung, Myung Jin" sort="Chung, Myung Jin" uniqKey="Chung M" first="Myung Jin" last="Chung">Myung Jin Chung</name>
<name sortKey="Kim, Kyunga" sort="Kim, Kyunga" uniqKey="Kim K" first="Kyunga" last="Kim">Kyunga Kim</name>
<name sortKey="Kim, Kyunga" sort="Kim, Kyunga" uniqKey="Kim K" first="Kyunga" last="Kim">Kyunga Kim</name>
<name sortKey="Kim, Tae Jung" sort="Kim, Tae Jung" uniqKey="Kim T" first="Tae Jung" last="Kim">Tae Jung Kim</name>
<name sortKey="Kim, Tae Sung" sort="Kim, Tae Sung" uniqKey="Kim T" first="Tae Sung" last="Kim">Tae Sung Kim</name>
<name sortKey="Lee, Kyung Soo" sort="Lee, Kyung Soo" uniqKey="Lee K" first="Kyung Soo" last="Lee">Kyung Soo Lee</name>
</country>
</tree>
</affiliations>
</record>
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