Key result
Pleural effusion in COVID-19 predicts ~122% higher 30-day mortality, irrespective of volume or density.
Why the study?
The prognostic significance and role of pleural effusion in predicting clinical outcomes in COVID-19 patients required clarification.
Does the presence of pleural effusion predict 30-day mortality, ICU admission, and mechanical ventilation in patients with COVID-19?
Cohort (n=1,183)
Yes
Does the presence of pleural effusion predict 30-day mortality, ICU admission, and mechanical ventilation in patients with COVID-19?
Effect estimate: HR 2.22 (95% CI 1.65-2.99)
p-value: p=<0.001
The presence of pleural effusion on chest CT in COVID-19 patients is an independent predictor of increased 30-day mortality.
Pleural effusion on CT may flag higher short-term risk in COVID-19; leaves open its incremental value for risk models or trials.
PURPOSE: This study evaluates the prognostic significance of pleural effusion (PE) in COVID-19 patients across thirteen centers in Germany, aiming to clarify its role in predicting clinical outcomes. METHODS: In this retrospective analysis within the RACOON project (Radiological Cooperative Network of the COVID-19 pandemic), 1183 patients (29.3 % women, 70.7 % men) underwent chest CT to assess PE. We investigated PE's association with 30-day mortality, ICU admission, and the need for mechanical ventilation. RESULTS: PE was detected in 31.5 % of patients, showing a significant correlation with 30-day mortality (47.5 % in non-survivors vs. 27.3 % in survivors, p < 0.001), with a hazard ratio of 2.22 (95 % CI 1.65-2.99, p < 0.001). No significant association was found between PE volume or density and mortality. ICU admissions were noted in 46.8 % of patients, while mechanical ventilation was required for 26.7 %. CONCLUSION: Pleural effusion is present in a significant portion of COVID-19 patients and independently predicts increased 30-day mortality, underscoring its value as a prognostic marker. Its identification, irrespective of volume or density, should be a priority in radiological reports to guide clinical decision-making.
No takes yet. Share an insight, caveat, or question.
Bucher et al. (2024) conducted a cohort in COVID-19 (n=1,183). Pleural effusion vs. No pleural effusion was evaluated on 30-day mortality (HR 2.22, 95% CI 1.65-2.99, p=<0.001). The presence of pleural effusion in COVID-19 patients independently predicted increased 30-day mortality (HR 2.22; 95% CI 1.65-2.99; p<0.001), irrespective of effusion volume or density.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: