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Purpose <p>To validate the Simplified Chest CT Severity Score (SCCTSS) for prognostic stratification of COVID-19 pneumonia in a resource-limited Gaza cohort and compare its diagnostic accuracy and interobserver reliability against the established Chest CT Score (CCTS).</p> Materials and methods <p>In this retrospective cohort study, 360 adult patients with RT-PCR–confirmed COVID-19 underwent non-contrast chest CT within 72&#xa0;h of admission (September 2020–June 2022). SCCTSS assessed three parameters, opacity type, extent, and distribution, with scores ranging from 0 to 7 and classified into no involvement (0), mild (3), moderate (4–5), and severe (6–7) disease. CCTS scores ranged from 0 to 25 and were categorized as no involvement (0), mild (1–8), moderate (9–16), and severe (17–25). Interobserver agreement was measured by Cohen’s kappa. Diagnostic accuracy for mortality prediction was evaluated via sensitivity, specificity, ROC curves, and Kaplan–Meier survival analyses.</p> Results <p>SCCTSS demonstrated almost perfect interobserver reliability (κ = 0.883), comparable to CCTS (κ = 0.870). Mortality was significantly associated with higher SCCTSS categories; 58.5% of non-survivors had severe scores (6–7), compared to 3.7% of survivors (<i>p</i> &lt; 0.001). At the optimal cutoff (≥ 3.5), SCCTSS sensitivity was 93.2%, specificity 90.1%, with AUC 0.933. CCTS (cutoff ≥ 8.5) showed 89.8% sensitivity, 93.4% specificity, and AUC 0.948. Kaplan–Meier analysis confirmed significantly reduced 30-day survival in patients with scores above these thresholds (<i>p</i> &lt; 0.001).</p> Conclusions <p>SCCTSS is a simple, reproducible, and effective CT scoring tool for COVID-19 prognostication, suitable for rapid risk stratification in resource-limited environments.</p>

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Prognostic validation of a simplified chest CT severity score in COVID-19 patients from resource-limited Gaza

  • 期刊论文

  • 发表日期：

    2025年10月18日

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  • Husam H. Mansour,
  • Noor Khairiah A. Karim,
  • Noor Diyana Osman,
  • Rohayu Hami,
  • Yasser S. Alajerami

摘要

Purpose

To validate the Simplified Chest CT Severity Score (SCCTSS) for prognostic stratification of COVID-19 pneumonia in a resource-limited Gaza cohort and compare its diagnostic accuracy and interobserver reliability against the established Chest CT Score (CCTS).

Materials and methods

In this retrospective cohort study, 360 adult patients with RT-PCR–confirmed COVID-19 underwent non-contrast chest CT within 72 h of admission (September 2020–June 2022). SCCTSS assessed three parameters, opacity type, extent, and distribution, with scores ranging from 0 to 7 and classified into no involvement (0), mild (3), moderate (4–5), and severe (6–7) disease. CCTS scores ranged from 0 to 25 and were categorized as no involvement (0), mild (1–8), moderate (9–16), and severe (17–25). Interobserver agreement was measured by Cohen’s kappa. Diagnostic accuracy for mortality prediction was evaluated via sensitivity, specificity, ROC curves, and Kaplan–Meier survival analyses.

Results

SCCTSS demonstrated almost perfect interobserver reliability (κ = 0.883), comparable to CCTS (κ = 0.870). Mortality was significantly associated with higher SCCTSS categories; 58.5% of non-survivors had severe scores (6–7), compared to 3.7% of survivors (p < 0.001). At the optimal cutoff (≥ 3.5), SCCTSS sensitivity was 93.2%, specificity 90.1%, with AUC 0.933. CCTS (cutoff ≥ 8.5) showed 89.8% sensitivity, 93.4% specificity, and AUC 0.948. Kaplan–Meier analysis confirmed significantly reduced 30-day survival in patients with scores above these thresholds (p < 0.001).

Conclusions

SCCTSS is a simple, reproducible, and effective CT scoring tool for COVID-19 prognostication, suitable for rapid risk stratification in resource-limited environments.