Combination of Chest Computed Tomography Value and Clinical Laboratory Data for the Prognostic Risk Evaluation of Patients with COVID-19

Figures & data

Figure 1 The cross-section of the chest CT image at the 4^th thoracic vertebra and the red marking area was the PMA.

Table 1 Comparison of General Data Between COVID-19 Patients in the Survival and Death Groups

Indicator	Survival Group	Death Group	X^2	P-value
Gender
Male	187 (60.9%)	70 (81.4%)
Female	120 (39.1%)	16 (18.6%)	12.455	<0.001
Age
≤60 years old	73 (23.8%)	4 (4.7%)
>60 years old	234 (76.2%)	82 (95.3%)	15.601	<0.001
Body temperature
Normal	247 (80.5%)	70 (81.4%)
Rise	60 (19.5%)	16 (18.6%)	0.038	0.845
Heart rate
Normal	220 (71.7%)	56 (65.1%)
Increase	87 (28.3%)	30 (34.9%)		0.242*
Inoculation of vaccine
No	100 (32.6%)	41 (47.7%)
One dose	36 (11.7%)	15 (17.4%)
Two doses	59 (19.2%)	15 (17.4%)
Three doses	112 (36.5%)	15 (17.4%)	13.61	0.003
Malignant tumor
No	270 (87.9%)	73 (84.9%)
Yes	37 (12.1%)	13 (15.1%)	0.568	0.451
Hypertension
No	171 (55.7%)	27 (31.4%)
Yes	136 (44.3%)	59 (68.6%)	15.875	<0.001
Coronary heart disease
No	304 (99.0%)	85 (98.8%)
Yes	3 (1.0%)	1 (1.2%)		1.000*
Diabetes mellitus
No	209 (68.1%)	51 (59.3%)
Yes	98 (31.9%)	35 (40.7%)	2.311	0.128
Chronic renal insufficiency
No	250 (81.4%)	55 (64.0%)
Yes	57 (18.6%)	31 (36.0%)	11.812	0.001
BMI
≥18.5	282 (91.9%)	84 (97.7%)
<18.5	25 (8.1%)	2 (2.3%)	3.554	0.059

Note: *Fisher’s exact probabilities.

Table 2 Comparison of Pectoralis Muscle CT Value Between COVID-19 Patients in the Survival and Death Groups

Indicator	Survival Group	Death Group	X^2	P-value
PMI
High	155 (50.5%)	12 (14.0%)
Low	152 (49.5%)	74 (86.0%)	36.697	<0.001
PSS
0	159 (51.8%)	18 (20.9%)
1	98 (31.9%)	25 (29.1%)
2	39 (12.7%)	21 (24.4%)
3	11 (3.6%)	22 (25.6%)	59.137	<0.001

Table 3 Comparison of Laboratory Parameters Between COVID-19 Patients in the Survival and Death Groups

Indicator	Survival Group	Death Group	X^2	P-value
Hs-TnT
Normal	93 (30.3%)	6 (7.0%)
Increase	214 (69.7%)	80 (93.0%)	19.381	<0.001
NT-proBNP
Normal	106 (34.5%)	9 (10.5%)
Increase	201 (65.5%)	77 (89.5%)	18.792	<0.001
PCT
Normal	177 (57.7%)	33 (38.4%)
Increase	130 (42.3%)	53 (61.6%)	10.039	0.002
CRP
Normal	32 (10.4%)	0 (0.0%)
Increase	275 (89.6%)	86 (100.0%)	9.759	0.002
DD
Normal	86 (28.0%)	4 (4.7%)
Increase	221 (72.0%)	82 (95.3%)	20.766	<0.001
CK
Normal	227 (73.9%)	54 (62.8%)
Increase	80 (26.1%)	32 (37.2%)	4.099	0.043
CKMB
Normal	242 (78.8%)	49 (57.0%)
Increase	65 (21.2%)	37 (43.0%)	16.690	<0.001
LDH
Normal	158 (51.5%)	9 (10.5%)
Increase	149 (48.5%)	77 (89.5%)	46.215	<0.001
BUN
Normal	228 (74.3%)	35 (40.7%)
Increase	79 (25.7%)	51 (59.3%)	34.199	<0.001
Cre
Normal	216 (70.4%)	38 (44.2%)
Increase	91 (29.6%)	48 (55.8%)	20.131	<0.001
GLU
Normal	103 (33.6%)	14 (16.3%)
Increase	204 (66.4%)	72 (83.7%)	9.585	0.002
β-HB
Normal	162 (52.8%)	39 (45.3%)
Increase	145 (47.2%)	47 (54.7%)	1.480	0.224
ALB
Normal	59 (19.2%)	6 (7.0%)
Decrease	248 (80.8%)	80 (93.0%)	7.293	0.007
ALT
Normal	271 (88.3%)	68 (79.1%)
Increase	36 (11.7%)	18 (20.9%)	4.801	0.028
AST
Normal	191 (62.2%)	33 (38.4%)
Increase	116 (37.8%)	53 (61.6%)	15.582	<0.001
GGT
Normal	242 (78.8%)	60 (69.8%)
Increase	65 (21.2%)	26 (30.2%)	3.099	0.078
ALP
Normal	289 (94.1%)	74 (86.0%)
Increase	18 (5.9%)	12 (14.0%)	6.236	0.013
WBC
Normal	246 (80.1%)	56 (65.1%)
Increase	61 (19.9%)	30 (34.9%)	8.511	0.004*
Neu
Normal	246 (80.1%)	52 (60.5%)
Increase	61 (19.9%)	34 (39.5%)	14.174	<0.001
Lym
Normal	303 (98.7%)	85 (98.8%)
Increase	4 (1.3%)	1 (1.2%)		1.000*
Mono
Normal	246 (80.1%)	76 (88.4%)
Increase	61 (19.9%)	10 (11.6%)	3.083	0.079
Hgb
Normal	201 (65.5%)	49 (57.0%)
Decrease	106 (34.5%)	37 (43.0%)	2.095	0.148
PLT
Normal	278 (90.6%)	73 (84.9%)
Decrease	29 (9.4%)	13 (15.1%)	2.263	0.133
Saturation of blood oxygen
Normal	224 (73.0%)	39 (45.3%)
Decrease	83 (27.0%)	47 (54.7%)	23.144	<0.001

Note: *Fisher’s exact probabilities.

Table 4 Analysis of the Risk Factors for the Death of COVID-19 Patients

Related Indicators	N	Univariate Analysis		Multivariate Analysis
		OR (95% CI)	P-value	OR (95% CI)	P-value
Gender
Male	257
Female	136	0.356 (0.198, 0.642)	<0.001	0.355 (0.16, 0.745)	0.008
Age
≤60 years old	77
>60 years old	316	6.395 (2,266.18.047)	<0.001	3.938 (1,221.15.9)	0.033
Body temperature
Normal	317
Increase	76	0.941 (0,510.1.735)	0.845	-
Heart rate
Normal	276
Increase	117	1.355 (0,815.2.252)	0.242	-
Saturation of blood oxygen
Normal	263
Decrease	130	3.252 (1,985.5.328)	<0.001	1.338 (0,676.2.627)	0.398
Inoculation of vaccine
No	141
One dose	51	1.016 (0,503.2.054)	0.964	0.601 (0,227.1.526)	0.292
Two doses	74	0.62 (0,316.1.216)	0.164	0.584 (0,229.1.43)	0.248
Three doses	127	0.327 (0,171.0.626)	<0.001	0.622 (0,261.1.43)	0.271
Tumor
No	343
Yes	50	1.3 (0,657.2.572)	0.452	-
Hypertension
No	198
Yes	195	2.748 (1,653.4.566)	<0.001	1.642 (0,809.3.333)	0.169
Coronary heart disease
No	389
Yes	4	1.192 (0,122.11.608)	0.88	-
Diabetes mellitus
No	260
Yes	133	1.464 (0,894.2.395)	0.13	-
Chronic renal insufficiency
No	305
Yes	88	2.472 (1,461.4.183)	<0.001	1.189 (0,504.2.801)	0.693
BMI
≥18.5	366
<18.5	27	0.269 (0,062.1.157)	0.078	-
PMI
High	167
Low	226	6.288 (3,284.12.042)	<0.001	4.985 (2,336.11.443)	<0.001
PSS
0	177
1	123	2.253 (1,169.4.343)	0.015	1.258 (0,525.3.052)	0.608
2	60	4.756 (2,314.9.776)	<0.001	2.351 (0,903.6.25)	0.082
3	33	17.667 (7,382.42.278)	<0.001	6.486 (2,082.21.416)	0.002
Hs-TnT
Normal	99
Increase	294	5.794 (2,441.13.756)	<0.001	1.002 (0.32, 3.421)	0.998
NT-proBNP
Normal	115
Increase	278	4.512 (2,176.9.357)	<0.001	1.746 (0,672.4.842)	0.265
CT
Normal	210
Increase	183	2.187 (1,340.3.570)	0.002	1.503 (0.73, 3.123)	0.27
CRP
Normal	32
Increase	361	15.125 (2,045.112.324)	0.008	1.23 (0,142.25.361)	0.834
DD
Normal	90
Increase	303	7.977 (2,836.22.436)	<0.001	2.27 (0,712.9.154)	0.2
CK
Normal	281
Increase	112	1.681 (1,014.2.789)	0.044	0.734 (0,348.1.517)	0.408
CKMB
Normal	291
Increase	102	2.811 (1,693.4.668)	<0.001	2.007 (0.98, 4.14)	0.057
LDH
Normal	167
Increase	226	9.072 (4,390.18.747)	<0.001	3.857 (1,571.10.266)	0.004
BUN
Normal	263
Increase	130	4.205 (2,549.6.937)	<0.001	1.532 (0,659.3.627)	0.325
Cre
Normal	254
Increase	139	2.998 (1,835.4.899)	<0.001	1.53 (0,608.3.824)	0.363
GLU
Normal	117
Increase	276	2.597 (1,397.4.825)	0.003	1.399 (0,633.3.208)	0.414
β-HB
Normal	201
Increase	192	1.346 (0,833.2.176)	0.225	-
ALB
Normal	65
Decrease	328	3.172 (1,320.7.623)	0.01	0.679 (0,213.2.35)	0.523
ALT
Normal	339
Increase	54	1.993 (1,066.3.723)	0.031	1.41 (0,548.3.623)	0.474
AST
Normal	224
Increase	169	2.644 (1,617.4.325)	<0.001	0.698 (0.31, 1.537)	0.377
GGT
Normal	302
Increase	91	1.613 (0,944.2.756)	0.08	0.874 (0,371.2.062)	0.759
ALP
Normal	363
Increase	30	2.604 (1,201.5.644)	0.015	1.082 (0,359.3.212)	0.888
WBC
Normal	302
Increase	91	2.16 (1,278.3.651)	0.004	1.621 (0,392.6.804)	0.505
Neu
Normal	298
Increase	95	2.637 (1,575.4.414)	<0.001	0.852 (0,217.3.237)	0.815
Lym
Normal	388
Increase	5	0.891 (0,098.8.079)	0.918	-
Mono
Normal	322
Increase	71	0.531 (0,259.1.086)	0.083	-
Hgb
Normal	250
Decrease	143	1.432 (0,879.2.331)	0.149	-

Figure 2 Prognostic nomogram model of risk for death in patients with COVID-19.

Notes: PPS, PMI, LDH, gender and age of a single patient were corresponding to the top scoring scale bar. Subsequently, the five scores were added up. According to the total score, the corresponding value in the Total Points scale strip was determined. The value in the Risk scale strip matched the above Total Point value, and the patient’s risk of death can be predicted.

Figure 3 Consistency between the predicted mortality and actual observed results in COVID-19 patients was validated by the calibration curve.

Figure 4 ROC curve of the prognostic nomogram model of risk for death in patients with COVID-19.