CT Radiomics, Radiologists and Clinical Information in Predicting Outcome of Patients with COVID-19 Pneumonia

Homayounieh, Fatemeh; Ebrahimian, Shadi; Babaei, Rosa; Karimi Mobin, Hadi; Zhang, Eric; Bizzo, Bernardo Canedo; Mohseni, Iman; Digumarthy, Subba R.; Kalra, Mannudeep K.

PURPOSE: To compare prediction of disease outcome, severity, and patient triage in COVID-19 pneumonia with whole lung radiomics, radiologists’ interpretation, and clinical variables. METHODS: Our IRB-approved retrospective study included 315 adult patients (mean age 56 (21-100) years, 190 males, 125 females) with COVID-19 pneumonia who underwent non-contrast chest CT. All patients (inpatients, n=210; outpatients, n=105) were followed up for at least two-weeks to record disease outcome. Clinical variables such as presenting symptoms, laboratory data, peripheral oxygen saturation, and comorbid diseases were recorded. Two radiologists assessed each CT in consensus and graded the extent of pulmonary involvement (by percentage of involved lobe) and type of opacities within each lobe. We obtained radiomics for the entire lung and multiple logistic regression analyses with areas under the curve (AUC) as outputs were performed. RESULTS: Most patients (276/315,88%) recovered from COVID-19 pneumonia; 36/315 patients (11%) died and 3/315 patients (1%) remain admitted in the hospital. Radiomics differentiated chest CT in outpatient vs inpatient with an AUC of 0.84 (p<0.005), while radiologists’ interpretations of disease extent and opacity type had an AUC of 0.69 (p<0.0001). Whole lung radiomics were superior to the radiologists’ interpretation for predicting patient outcome in terms of ICU admission (AUC:0.75 vs 0.68) and death (AUC:0.81 vs 0.68) (p<0.002). Addition of clinical variables to radiomics improved the AUC to 0.84 for predicting ICU admission. CONCLUSION: Radiomics from non-contrast chest CT were superior to radiologists’ assessment of extent and type of pulmonary opacities in predicting COVID-19 pneumonia outcome, disease severity, and patient triage.