Evidence map›Paper›PMID 36728781›Full record

ArticleJournal of computer assisted tomography

Does the Thymus Index Predict COVID-19 Severity?

Ocal Berkan, Ilker Kiziloğlu, Ercan Keles, Lale Duman, Mehmet Bozkurt, Zehra Adibelli, Guray Oncel, Nevsin Berkan, Yildiz Ekemen Keles, Jeremy H Jones and 10 more

Open access · greenAbstract readMulticenter Study
In one paragraph

Article in Journal of computer assisted tomography. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.6field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 5 citations in OpenAlex.

  1. Review
  2. Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors at 6 institutions in 3 countries.

Ocal BerkanFrom the Departments of Cardiovascular Surgery.
Ilker KiziloğluGeneral Surgery, İzmir Çiğli Training and Research Hospital.
Ercan KelesFrom the Departments of Cardiovascular Surgery.
Lale DumanDepartment of Radiology, Bornova Türkan Özilhan Hospital.
Mehmet BozkurtDepartment of Radiology, Tepecik Education and Research Hospital.
Zehra AdibelliDepartment of Radiology, Bozyaka Education and Research Hospital.
Guray OncelDepartment of Radiology, İzmir Çiğli Training and Research Hospital, İzmir, Turkey.
Nevsin BerkanMolecular Biology & Genetics, University of Lorraine, Nancy, France.
Yildiz Ekemen KelesDepartment of Pediatric İnfection Diseases, Tepecik Education and Research Hospital, İzmir.
Jeremy H JonesDepartment of Academic Writing, Kocaeli University, Umuttepe, İzmit.
Abdurrahman Hamdi InanDepartment of Gynecology and Obstetrics, Bornova Türkan Özilhan Hospital, İzmir.
Cihan SolakDepartment of Radiology, Adana Guney Hospital, Adana.
Mustafa EmiroğluDepartment of General Surgery, Tepecik Education and Research Hospital.
Mehmet YildirimDepartment of General Surgery, Bozyaka Education and Research Hospital.
Ayberk DursunDepartment of General Surgery, Tepecik Education and Research Hospital.
Enver IlhanDepartment of General Surgery, Bozyaka Education and Research Hospital.
Asuman CamyarDepartment of Allergy and Immunology, İzmir Çiğli Training and Research Hospital.
Ozge InceerDepartment of Infectious Disease and Clinical Microbiology, İzmir Çiğli Training and Research Hospital.
Ahmet NartGeneral Surgery, İzmir Çiğli Training and Research Hospital.
Mehmet Birhan YilmazDepartment of Cardiology, Faculty of Medicine, Dokuz Eylul University, İzmir, Turkey.
Izmir University · TREducation and Research Institute · USEducation Training And Research · USDokuz Eylül University · TRKocaeli Üniversitesi · TRUniversité de Lorraine · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe COVID-19 (coronavirus disease 2019) pandemic is a global health emergency that is straining health care resources. Identifying patients likely to experience severe illness would allow more targeted use of resources. This study aimed to investigate the association between the thymus index (TI) on thorax computed tomography (CT) and prognosis in patients with COVID-19.

methodsA multicenter, cross-sectional, retrospective study was conducted between March 17 and June 30, 2020, in patients with confirmed COVID-19. The patients' clinical history and laboratory data were collected after receiving a signed consent form. Four experienced radiologists who were blinded to each other and patient data performed image evaluation. The appearance of the thymus was assessed in each patient using 2 published systems, including the TI and thymic morphology. Exclusion criteria were lack of initial diagnostic thoracic CT, previous sternotomy, pregnancy, and inappropriate images for thymic evaluation. A total of 2588 patients with confirmed COVID-19 and 1231 of these with appropriate thoracic CT imaging were included. Multivariable analysis was performed to predict the risk of severe disease and mortality.

resultsThe median age was 45 (interquartile range, 33-58) years; 52.2% were male. Two hundred forty-nine (20.2%) patients had severe disease, and 60 (4.9%) patients died. Thymus index was significantly associated with mortality and severe disease (odds ratios, 0.289 [95% confidence interval, 0.141-0.588; P = 0.001]; and 0.266 [95% confidence interval, 0.075-0.932; P = 0.038]), respectively. Perithymic lymphadenopathy on CT imaging had a significantly strong association with grades of TI in patients with severe disease and death ( V = 0.413 P = 0.017; and V = 0.261 P = 0.002, respectively). A morphologically assessable thymus increased the probability of survival by 17-fold and the absence of severe disease by 12-fold.

conclusionAssessment of the thymus in patients with COVID-19 may provide useful prognostic data for both disease severity and mortality.

Indexed as

COVID-19Cross-Sectional StudiesFemaleHumansMaleMiddle AgedPrognosisRetrospective StudiesSARS-CoV-2Severity of Illness Index

Identifiers

PMID36728781
PMCPMC10044592
OpenAlexW4318917767

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.