Relationship between clinical types and radiological subgroups defined by latent class analysis in 2019 novel coronavirus pneumonia caused by SARS-CoV-2

• Published in: European radiology Vol. 30; no. 11; pp. 6139 - 6150
• Main Authors: Fang, Xu, Li, Xiao, Bian, Yun, Ji, Xiang, Lu, Jianping
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.11.2020
• Subjects: Betacoronavirus; Chest; Coronavirus Infections - diagnostic imaging; Coronavirus Infections - pathology; Coronavirus Infections - physiopathology; COVID-19; Cross-Sectional Studies; Diagnostic Radiology; Female; Humans; Imaging; Internal Medicine; Interventional Radiology; Latent Class Analysis; Lung - diagnostic imaging; Lung - pathology; Lung - physiopathology; Male; Medicine; Medicine & Public Health; Middle Aged; Neuroradiology; Pandemics; Pneumonia, Viral - diagnostic imaging; Pneumonia, Viral - pathology; Pneumonia, Viral - physiopathology; Radiology; Retrospective Studies; SARS-CoV-2; Severity of Illness Index; Tomography, X-Ray Computed - methods; Ultrasound; Pneumonia, Latent class analysis; Tomography, X-ray computed; Coronavirus infections
• ISSN: 0938-7994; 1432-1084; 1432-1084
• DOI: 10.1007/s00330-020-06973-9

Objectives To investigate whether meaningful subgroups sharing the CT features of patients with COVID-19 pneumonia could be identified using latent class analysis (LCA) and explore the relationship between the LCA-derived subgroups and clinical types. Methods This retrospective review included 499 patients with confirmed COVID-19 pneumonia between February 11 and March 8, 2020. Subgroups sharing the CT features were identified using LCA. Univariate and multivariate logistic regression models were utilized to analyze the association between clinical types and the LCA-derived subgroups. Results Two radiological subgroups were identified using LCA. There were 228 subjects (45.69%) in class 1 and 271 subjects (54.31%) in class 2. The CT findings of class 1 were smaller pulmonary infection volume, more peripheral distribution, more GGO, more maximum lesion range ≤ 5 cm, a smaller number of lesions, less involvement of lobes, less air bronchogram, less dilatation of vessels, less hilar and mediastinal lymph node enlargement, and less pleural effusion than the CT findings of class 2. Univariate analysis demonstrated that older age, therapy, presence of fever, presence of hypertension, decreased lymphocyte count, and increased CRP levels were significant parameters associated with an increased risk for class 2. Multivariate analyses revealed that the patients with clinically severe type disease had a 1.97-fold risk of class 2 than the patients with clinically moderate-type disease. Conclusions The demographic and clinical differences between the two radiological subgroups based on the LCA were significantly different. Two radiological subgroups were significantly associated with clinical moderate and severe types. Key Points • Two radiological subgroups were identified using LCA. • Older age, therapy, presence of fever, presence of hypertension, decreased lymphocyte count, and increased CRP levels were significant parameters with an increased risk for class 2 defined by LCA. • Patients with clinically severe type had a 1.97-fold higher risk of class 2 defined by LCA in comparison with patients showing clinically moderate-type disease.