Impact of Hiatal Hernia on CT-Severity Scores and Survival of COVID-19 Patients

Abstract

Aim: We aimed to investigate the impact of hiatal hernia (HH) on computed tomography (CT) findings, CT-severity scores (CT-SS), intensive care unit (ICU) admission, and mortality rates of patients with Coronavirus disease-2019 (COVID-19). Materials and Methods: Our study was a single-center retrospective analysis of COVID-19 patients admitted to our hospital between July and October 2021. One hundred-forty four of these patients had HH. We also randomly selected 144 COVID-19 patients without HH as the control group. So, the total study population included 288 patients aged ≥18 years. Chest CT scans examined by the radiologist for the presence of HH and CT-SSs were calculated using a visual scoring system. Results: The presence of HH was statistically associated with COVID-19 Reporting and Data System classification of initial CT (p=0.002) and CT-SS (p<0.001). Also, HH was statistically associated with ground-glass opacity, pericardial effusion, crazy paving pattern, pleural, bronchial wall thickening and reversed halo sign in CT imaging. Multivariate analysis showed that HH was associated with a higher rate of need for ICU admission [odds ratio (OR): 2.47, p=0.01] and mortality (OR: 2.04, p=0.02). Conclusion: The presence of a HH has important implications for the severity of pneumonia and increased ICU admission and mortality in COVID-19 patients.

Keywords

• hiatal hernia
• covid-19
• computed tomography
• pneumonia