Prevalence and clinical consequences of atelectasis in SARS-CoV-2 pneumonia: a computed tomography retrospective cohort study.

Abstract

BACKGROUND:

The aim of the study is to estimate the prevalence of atelectasis assessed with computer tomography (CT) in SARS-CoV-2 pneumonia and the relationship between the amount of atelectasis with oxygenation impairment, Intensive Care Unit admission rate and the length of in-hospital stay.

PATIENTS AND METHODS:

Two-hundred thirty-seven patients admitted to the hospital with SARS-CoV-2 pneumonia diagnosed by clinical, radiology and molecular tests in the nasopharyngeal swab who underwent a chest computed tomography because of a respiratory worsening from Apr 1 to Apr 30, 2020 were included in the study. Patients were divided into three groups depending on the presence and amount of atelectasis at the computed tomography: no atelectasis, small atelectasis (< 5% of the estimated lung volume) or large atelectasis (> 5% of the estimated lung volume). In all patients, clinical severity, oxygen-therapy need, Intensive Care Unit admission rate, the length of in-hospital stay and in-hospital mortality data were collected.

RESULTS:

Thirty patients (19%) showed small atelectasis while eight patients (5%) showed large atelectasis. One hundred and seventeen patients (76%) did not show atelectasis. Patients with large atelectasis compared to patients with small atelectasis had lower SatO2/FiO2 (182 vs 411 respectively, p = 0.01), needed more days of oxygen therapy (20 vs 5 days respectively, p = 0,02), more frequently Intensive Care Unit admission (75% vs 7% respectively, p < 0.01) and a longer period of hospitalization (40 vs 14 days respectively p < 0.01).

CONCLUSION:

In patients with SARS-CoV-2 pneumonia, atelectasis might appear in up to 24% of patients and the presence of larger amount of atelectasis is associated with worse oxygenation and clinical outcome.

• Authors: Álvaro Mingote, Andrea Albajar, Paulino García Benedito, Jessica Garcia-Suarez, Paolo Pelosi, Lorenzo Ball, Javier García-Fernández
• Journal: BMC pulmonary medicine (BMC Pulm Med) Vol. 21 Issue 1 Pg. 267 (Aug 17 2021) ISSN: 1471-2466 [Electronic] England
• PMID: 34404383 (Publication Type: Journal Article)
• Copyright: © 2021. The Author(s).

Topics

• Aged
• COVID-19 (diagnosis, mortality, physiopathology)
• COVID-19 Testing (methods)
• Female
• Humans
• Hypoxia (etiology, therapy)
• Intensive Care Units (statistics & numerical data)
• Length of Stay (statistics & numerical data)
• Lung (diagnostic imaging)
• Lung Volume Measurements (methods)
• Male
• Pneumonia, Viral (diagnostic imaging, etiology, physiopathology, therapy)
• Prevalence
• Pulmonary Atelectasis (diagnostic imaging, epidemiology, etiology, physiopathology)
• Respiration, Artificial (methods, statistics & numerical data)
• Retrospective Studies
• SARS-CoV-2 (isolation & purification)
• Severity of Illness Index
• Spain (epidemiology)
• Tomography, X-Ray Computed (methods, statistics & numerical data)