International Journal of General Medicine (Jun 2023)

High Fever, Wide Distribution of Viral Pneumonia, and Pleural Effusion are More Critical Findings at the First Visit in Predicting the Prognosis of COVID-19: A Single Center, retrospective, Propensity Score-Matched Case–Control Study

  • Shinoda M,
  • Ota S,
  • Yoshida Y,
  • Hirouchi T,
  • Shinada K,
  • Sato T,
  • Morikawa M,
  • Ishii N,
  • Shinkai M

Journal volume & issue
Vol. Volume 16
pp. 2337 – 2348

Abstract

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Masahiro Shinoda,1 Shinichiro Ota,1 Yuto Yoshida,1,2 Takatomo Hirouchi,1,2 Kanako Shinada,1 Takashi Sato,1 Miwa Morikawa,1 Naoki Ishii,3 Masaharu Shinkai1 1Department of Respiratory Medicine, Tokyo Shinagawa Hospital, Tokyo, Japan; 2Department of Respiratory Medicine, Toho University Ohashi Medical Center, Tokyo, Japan; 3Department of Gastroenterology, Tokyo Shinagawa Hospital, Tokyo, JapanCorrespondence: Masahiro Shinoda, Department of Respiratory Medicine, Tokyo Shinagawa Hospital, 6-3-22 Higashi-Oi, Shinagawa, Tokyo, 140-8522, Japan, Tel +81-3-3764-0511, Fax +81-3-3764-3415, Email [email protected]: Currently, infection control measures for SARS-COV2 are being relaxed, and it is important in daily clinical practice to decide which findings to focus on when managing patients with similar background factors.Methods: We retrospectively evaluated 66 patients who underwent blood tests (complete blood count, blood chemistry tests, and coagulation tests) and thin slice CT between January 1 and May 31, 2020, and performed a propensity score-matched case–control study. Cases and controls were a severe respiratory failure group (non-rebreather mask, nasal high-flow, and positive-pressure ventilation) and a non-severe respiratory failure group, matched at a ratio of 1:3 by propensity scores constructed by age, sex, and medical history. We compared groups for maximum body temperature up to diagnosis, blood test findings, and CT findings in the matched cohort. Two-tailed P-values < 0.05 were considered statistically significant.Results: Nine cases and 27 controls were included in the matched cohort. Significant differences were seen in maximum body temperature up to diagnosis (p=0.0043), the number of shaded lobes (p=0.0434), amount of ground-glass opacity (GGO) in the total lung field (p=0.0071), amounts of GGO (p=0.0001), and consolidation (p=0.0036) in the upper lung field, and pleural effusion (p=0.0117).Conclusion: High fever, the wide distribution of viral pneumonia, and pleural effusion may be prognostic indicators that can be easily measured at diagnosis in COVID-19 patients with similar backgrounds.Keywords: COVID-19, prognosis, fever, ground-glass opacity, consolidation, pleural effusion

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