Extrapulmonary CT Findings Predict In-Hospital Mortality in COVID-19. A Systematic Review and Meta-Analysis.

Abstract Background : Several prognostic factors have been identified for COVID-19 disease. Our aim was to elucidate the influence of non-pulmonary findings of thoracic computed tomography (CT) on unfavourable outcomes and in-hospital mortality in COVID-19 patients based on a large patient sample. Methods : MEDLINE library, Cochrane and SCOPUS databases were screened for the associations between CT-defined features and mortality in COVID-19 patients up to June 2021. In total, 22 studies were suitable for the analysis and included into the present analysis. Overall, data regarding 4 extrapulmonary findings could be pooled: pleural effusion, pericardial effusion, mediastinal lymphadenopathy, and coronary calcification. Results : The included studies comprised 7859 patients. The pooled odds ratios for the effect of the identified extrapulmonary findings on in-hospital mortality are as follows: pleural effusion, 4.76 [95% CI 2.97-7.62]; pericardial effusion, 1.21 [95% CI 0.74-1.98]; coronary calcification, 2.68 [95% CI 1.78-4.04]; mediastinal lymphadenopathy, 2.02 [95% CI 1.18-3.45]. Conclusions : Pleural effusion, mediastinal lymphadenopathy and coronary calcification have a relevant association with in-hospital mortality in COVID-19 patients and should be included as prognostic biomarker into clinical routine. Funding : None