Chest CT features and risk factors for patients with Omicron variant pneumonia: a multicenter retrospective clinical study

Abstract

Introduction: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) Omicron variant infection has become widespread in China as a result of the alterations in epidemic control and prevention policies. We identified the clinical characteristics and lung computed tomography (CT) imaging characteristics of patients infected during the early stage of the Omicron BA.5 wave in Shanghai to provide a guide to the diagnosis, treatment, and prognosis of infection.

Methodology: Clinical information and lung CT imaging characteristics of patients with Omicron variant infection admitted to three designated hospitals in Shanghai from March to June 2022 were analyzed retrospectively.

Results: A total of 958 patients were included in the analysis. Among the patients, 169 (17.64%) had pneumonia confirmed by CT, of whom 70.41% (119/169) had lesions in < 10% of the lung area. Older age, unvaccinated status, and comorbid chronic lung disease, cerebrovascular disease, kidney disease, or Alzheimer`s disease were associated with poor prognosis. In patients with coronavirus disease 2019 (COVID-19) pneumonia, a large lesion size was associated with a poor prognosis. Age ≥ 65 years, unvaccinated status, fever > 5 days, and lymphocyte count < 0.5×10⁹/L were risk factors for pneumonia.

Conclusions: Age ≥ 65 years, unvaccinated status, fever > 5 days, and lymphocyte count < 0.5×10⁹/L can be used to identify high-risk individuals who warrant a CT scan to screen for COVID-19 pneumonia, especially during the period of Omicron variant predominance. Concurrently, the importance of immunization should be emphasized to help people withstand the effects of Omicron variant infection.