Evidence map›Paper›PMID 40065711›Full record

ArticleJournal of Korean medical science2025

Temporal Radiographic Trajectory and Clinical Outcomes in COVID-19 Pneumonia: A Longitudinal Study.

Dong-Won Ahn, Yeonju Seo, Taewan Goo, Ji Bong Jeong, Taesung Park, Soon Ho Yoon

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Article in Journal of Korean medical science, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Dong-Won Ahn *Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.ORCID https://orcid.org/0000-0002-6641-2177
Yeonju Seo *Department of Statistics, Seoul National University, Seoul, Korea.ORCID https://orcid.org/0009-0005-7572-2205
Taewan GooDepartment of Statistics, Seoul National University, Seoul, Korea.ORCID https://orcid.org/0000-0001-9427-2290
Ji Bong JeongDepartment of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea. jibjeong@snu.ac.kr.ORCID https://orcid.org/0000-0003-4553-1721
Taesung ParkDepartment of Statistics, Seoul National University, Seoul, Korea.ORCID https://orcid.org/0000-0002-8294-590X
Soon Ho YoonDepartment of Radiology, Seoul National University Hospital, Seoul, Korea.ORCID https://orcid.org/0000-0002-3700-0165

Funding

Ministry of Science and ICT, South Korea 2021M3E5E3081425
6 · The paper itself

Abstract

backgroundCurrently, little is known about the relationship between the temporal radiographic latent trajectories, which are based on the extent of coronavirus disease 2019 (COVID-19) pneumonia and clinical outcomes. This study aimed to elucidate the differences in the temporal trends of critical laboratory biomarkers, utilization of critical care support, and clinical outcomes according to temporal radiographic latent trajectories.

methodsWe enrolled 2,385 patients who were hospitalized with COVID-19 and underwent serial chest radiographs from December 2019 to March 2022. The extent of radiographic pneumonia was quantified as a percentage using a previously developed deep-learning algorithm. A latent class growth model was used to identify the trajectories of the longitudinal changes of COVID-19 pneumonia extents during hospitalization. We investigated the differences in the temporal trends of critical laboratory biomarkers among the temporal radiographic trajectory groups. Cox regression analyses were conducted to investigate differences in the utilization of critical care supports and clinical outcomes among the temporal radiographic trajectory groups.

resultsThe mean age of the enrolled patients was 58.0 ± 16.9 years old, with 1,149 (48.2%) being male. Radiographic pneumonia trajectories were classified into three groups: The steady group (n = 1,925, 80.7%) exhibited stable minimal pneumonia, the downhill group (n = 135, 5.7%) exhibited initial worsening followed by improving pneumonia, and the uphill group (n = 325, 13.6%) exhibited progressive deterioration of pneumonia. There were distinct differences in the patterns of temporal blood urea nitrogen (BUN) and C-reactive protein (CRP) levels between the uphill group and the other two groups. Cox regression analyses revealed that the hazard ratios (HRs) for the need for critical care support and the risk of intensive care unit admission were significantly higher in both the downhill and uphill groups compared to the steady group. However, regarding in-hospital mortality, only the uphill group demonstrated a significantly higher risk than the steady group (HR, 8.2; 95% confidence interval, 3.08-21.98).

conclusionStratified pneumonia trajectories, identified through serial chest radiographs, are linked to different patterns of temporal changes in BUN and CRP levels. These changes can predict the need for critical care support and clinical outcomes in COVID-19 pneumonia. Appropriate therapeutic strategies should be tailored based on these disease trajectories.

Indexed as

COVID-19AdultAgedBiomarkersC-Reactive ProteinCritical CareFemaleHospitalizationHumansLongitudinal StudiesMaleMiddle AgedProportional Hazards ModelsSARS-CoV-2BiomarkersC-Reactive ProteinClinical OutcomeCOVID-19Critical Care SupportPneumonia Trajectory

Identifiers

PMID40065711
PMCPMC11893352

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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.