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

BMC Pulmonary Medicine

Andrea Albajar¹  Jessica Garcia-Suarez¹  Álvaro Mingote²  Javier García-Fernández²  Paolo Pelosi³  Lorenzo Ball³  Paulino García Benedito⁴ 

[1] Anaesthesia, Critical Care Department and Pain Unit, Puerta de Hierro Universitary Hospital - Majadahonda, c/Manuel de Falla, 1, 28222, Madrid, Spain;Anaesthesia, Critical Care Department and Pain Unit, Puerta de Hierro Universitary Hospital - Majadahonda, c/Manuel de Falla, 1, 28222, Madrid, Spain;Autonomous University of Madrid, Madrid, Spain;Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy;Anesthesia and Critical Care, IRCCS for Oncology and Neurosciences, San Martino Policlinico Hospital, Genoa, Italy;Radiodiagnostic Unit, Puerta de Hierro Universitary Hospital – Majadahonda, Madrid, Spain;

关键词: Atelectasis;    Coronavirus;    Chest computed tomography;    Mechanical ventilation;    Severe acute respiratory syndrome;   

DOI  :  10.1186/s12890-021-01638-9

来源: Springer

【 摘 要 】

BackgroundThe 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 methodsTwo-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.ResultsThirty 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).ConclusionIn 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.

【 授权许可】

CC BY