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Zhang M, Yin X, Li W, Zha Y, Zeng X, Zhang X, Cui J, Xue Z, Wang R, Liu C. A radiomics based approach using adrenal gland and periadrenal fat CT images to allocate COVID-19 health care resources fairly. BMC Med Imaging 2023; 23:181. [PMID: 37950171 PMCID: PMC10636917 DOI: 10.1186/s12880-023-01145-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 10/29/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND The value of radiomics features from the adrenal gland and periadrenal fat CT images for predicting disease progression in patients with COVID-19 has not been studied extensively. We assess the value of radiomics features from the adrenal gland and periadrenal fat CT images in predicting COVID-19 disease exacerbation. METHODS A total of 1,245 patients (685 moderate and 560 severe patients) were enrolled in a retrospective study. We proposed a 3D V-net to segment adrenal glands in onset CT images automatically, and periadrenal fat was obtained using inflation operation around the adrenal gland. Next, we built a clinical model (CM), three radiomics models (adrenal gland model [AM], periadrenal fat model [PM], and fusion of adrenal gland and periadrenal fat model [FM]), and radiomics nomogram (RN) after radiomics features extracted. RESULTS The auto-segmentation framework yielded a dice value 0.79 in the training set. CM, AM, PM, FM, and RN obtained AUCs of 0.717, 0.716, 0.736, 0.760, and 0.833 in the validation set. FM and RN had better predictive efficacy than CM (P < 0.0001) in the training set. RN showed that there was no significant difference in the validation set (mean absolute error [MAE] = 0.04) and test set (MAE = 0.075) between predictive and actual results. Decision curve analysis showed that if the threshold probability was between 0.4 and 0.8 in the validation set or between 0.3 and 0.7 in the test set, it could gain more net benefits using RN than FM and CM. CONCLUSIONS Radiomics features extracted from the adrenal gland and periadrenal fat CT images are related to disease exacerbation in patients with COVID-19.
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Affiliation(s)
- Mudan Zhang
- Department of Medical Imaging, International Exemplary Cooperation Base of Precision Imaging for Diagnosis and Treatment, NHC Key Laboratory of Pulmonary Immune-related Diseases, Guizhou Provincial People's Hospital, No. 83 Zhongshan East Road, Nan Ming District, 550002, Guiyang, Guiyang, Guizhou Province, China
- School Of Medicine, Guizhou University, 550000, Guiyang, Guizhou province, China
| | - Xuntao Yin
- Department of Radiology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Wuchao Li
- Department of Medical Imaging, International Exemplary Cooperation Base of Precision Imaging for Diagnosis and Treatment, NHC Key Laboratory of Pulmonary Immune-related Diseases, Guizhou Provincial People's Hospital, No. 83 Zhongshan East Road, Nan Ming District, 550002, Guiyang, Guiyang, Guizhou Province, China
- School Of Medicine, Guizhou University, 550000, Guiyang, Guizhou province, China
| | - Yan Zha
- Department of Nephrology, Guizhou Provincial People's Hospital, 550002, Guiyang, Guizhou province, China
| | - Xianchun Zeng
- Department of Medical Imaging, International Exemplary Cooperation Base of Precision Imaging for Diagnosis and Treatment, NHC Key Laboratory of Pulmonary Immune-related Diseases, Guizhou Provincial People's Hospital, No. 83 Zhongshan East Road, Nan Ming District, 550002, Guiyang, Guiyang, Guizhou Province, China
| | - Xiaoyong Zhang
- Department of Medical Imaging, International Exemplary Cooperation Base of Precision Imaging for Diagnosis and Treatment, NHC Key Laboratory of Pulmonary Immune-related Diseases, Guizhou Provincial People's Hospital, No. 83 Zhongshan East Road, Nan Ming District, 550002, Guiyang, Guiyang, Guizhou Province, China
| | - Jingjing Cui
- Shanghai United Imaging Intelligence, Co., Ltd, 201807, Shanghai, China
| | - Zhong Xue
- Shanghai United Imaging Intelligence, Co., Ltd, 201807, Shanghai, China
| | - Rongpin Wang
- Department of Medical Imaging, International Exemplary Cooperation Base of Precision Imaging for Diagnosis and Treatment, NHC Key Laboratory of Pulmonary Immune-related Diseases, Guizhou Provincial People's Hospital, No. 83 Zhongshan East Road, Nan Ming District, 550002, Guiyang, Guiyang, Guizhou Province, China.
- School Of Medicine, Guizhou University, 550000, Guiyang, Guizhou province, China.
| | - Chen Liu
- Department of Radiology, Southwest Hospital, Third Military Medical University (Army Medical University), 400038, Chongqing, China.
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Du H, Pan X, Liu N, Chen J, Chen X, Werring DJ, Ambler G, Li X, Chen R, Zhang Y, Huang H, Lin F, Xia P, Chen C, Zheng Z, Wu S, Lei H, Gao L, Huang M, Lin K, Xu X, Luo Y, Zhao Z, Li C, Lin H, Lin Y, Huang Z, Cao R, Chen L. The effect of vascular risk factor burden on the severity of COVID-19 illness, a retrospective cohort study. Respir Res 2020; 21:241. [PMID: 32957997 PMCID: PMC7503438 DOI: 10.1186/s12931-020-01510-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 09/14/2020] [Indexed: 01/08/2023] Open
Abstract
Background Patients with cardiovascular comorbidities are at high risk of poor outcome from COVID-19. However, how the burden (number) of vascular risk factors influences the risk of severe COVID-19 disease remains unresolved. Our aim was to investigate the association of severe COVID-19 illness with vascular risk factor burden. Methods We included 164 (61.8 ± 13.6 years) patients with COVID-19 in this retrospective study. We compared the difference in clinical characteristics, laboratory findings and chest computed tomography (CT) findings between patients with severe and non-severe COVID-19 illness. We evaluated the association between the number of vascular risk factors and the development of severe COVID-19 disease, using a Cox regression model. Results Sixteen (9.8%) patients had no vascular risk factors; 38 (23.2%) had 1; 58 (35.4%) had 2; 34 (20.7%) had 3; and 18 (10.9%) had ≥4 risk factors. Twenty-nine patients (17.7%) experienced severe COVID-19 disease with a median (14 [7–27] days) duration between onset to developing severe COVID-19 disease, an event rate of 4.47 per 1000-patient days (95%CI 3.10–6.43). Kaplan-Meier curves showed a gradual increase in the risk of severe COVID-19 illness (log-rank P < 0.001) stratified by the number of vascular risk factors. After adjustment for age, sex, and comorbidities as potential confounders, vascular risk factor burden remained associated with an increasing risk of severe COVID-19 illness. Conclusions Patients with increasing vascular risk factor burden have an increasing risk of severe COVID-19 disease, and this population might benefit from specific COVID-19 prevention (e.g., self-isolation) and early hospital treatment measures.
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Affiliation(s)
- Houwei Du
- Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China. .,Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China.
| | - Xiaobin Pan
- Department of Critical Care Medicine, Fujian Provincial Hospital South Branch, Fuzhou, China
| | - Nan Liu
- Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China.,Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China
| | - Junnian Chen
- Department of Critical Care Medicine, Fujian Medical University Union Hospital, Fuzhou, China
| | - Xiaoling Chen
- Department of Infectious Disease, Fujian Medical University Union Hospital, Fuzhou, China
| | | | - Gareth Ambler
- Statistical Science, University College London, London, UK
| | - Xiaoqing Li
- Fujian Center for Disease Control and Prevention, Fuzhou, China
| | - Ronghua Chen
- Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China.,Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
| | - Yixian Zhang
- Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China
| | - Huayao Huang
- Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China
| | - Feifei Lin
- Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China
| | - Pincang Xia
- Fujian Center for Disease Control and Prevention, Fuzhou, China
| | - Chao Chen
- Department of Neurology, Fuzhou Second Hospital Affiliated to Xiamen University, Fuzhou, China
| | - Zhenyang Zheng
- Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China.,Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
| | - Sangru Wu
- Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China
| | - Hanhan Lei
- Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China
| | - Lei Gao
- Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Mingxu Huang
- Department of Emergency Medicine, Fujian Medical University Union Hospital, Fuzhou, China
| | - Kexu Lin
- Department of Emergency Medicine, Fujian Medical University Union Hospital, Fuzhou, China
| | - Xiaoping Xu
- Department of Anesthesiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Yukun Luo
- Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Ziwen Zhao
- Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Chen Li
- Department of Otolaryngology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Hailong Lin
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Yu Lin
- Department of Colorectal Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Zhenghui Huang
- Department of Respiratory Medicine, Fujian Medical University Union Hospital, Fuzhou, China
| | - Rongxiang Cao
- Department of Respiratory Medicine, Fujian Medical University Union Hospital, Fuzhou, China
| | - Limin Chen
- Department of Respiratory Medicine, Fujian Medical University Union Hospital, Fuzhou, China
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