150: CT Chest as a Predictor of the Outcome of COVID-19 Patients in the Intensive Care Unit

INTRODUCTION: Chest CT is frequently used to diagnose and assess COVID-19 pneumonia in resource-starved locations that have limited access to polymerase chain reaction (RT-PCR) assays, as well as in high-risk patients with negative initial RT-PCR results The common chest CT findings of COVID-19 are multiple ground glass opacity, consolidation, and interlobular septal thickening in both lungs, which are mostly distributed under the pleura There are significant correlations between the degree of pulmonary inflammation and the main clinical symptoms and laboratory results We studied the relationship between the CT chest severity and the outcome of COVID-19 patients in ICU METHODS: A total of 265 patients with either positive or suspected COVID-19 underwent CT chest once they arrived to the emergency department All CT scans were reported by an experienced consultant radiologists Based on the CT findings we classified the patients into five categories: mild, moderate and severe, normal and atypical changes The requirement for intubation was reported, the length of stay in ICU and the outcome of these patients were documented and compared to the CT findings RESULTS: Out of the 265 cases, there was 154 severe cases, 75 moderate, 28 mild, 5 normal and 3 atypical cases Total mortality was 44 patients, the highest in the severe group 61 4%, 20 5% in the moderate, 4 5% in the mild, 9 1% in the normal and 4 5% in the atypical with P value 0 002 The need for intubation was 118 cases, 61% in the severe group, 25 4% in the moderate, 7 6% in the mild 3 4% in the normal and 2 5% in the atypical, P value 0 172 The average length of ICU stay was 13 48 days for severe, 13 22 days in moderate, 13 57 for mild, 9 2 days for normal and 32 3 days in the atypical CT groups CONCLUSIONS: CT scan severity had a relationship with the mortality, the higher mortality was in the severe CT changes group Again, there is relationship between the need for intubation and the severity of the CT scan, with higher intubation rate in the severe CT changes group There was no relationship between the length of ICU stay and the severity of the CT chest findings CT scan is an excellent tool to determine the need for intubation and the prediction of the outcome in COVID-19 patients in ICU