The prognostic relevance of pleural effusion in patients with COVID-19 - A German multicenter study

Bucher AM, Dietz J, Ehrengut C, Müller L, Schramm D, Akinina A, Drechsel M, Kloeckner R, Sieren M, Isfort P, Sähn MJ, Fink MA, Móré D, Melekh B, Meinel FG, Schön H, May M, Siegler L, Münzfeld H, Ruppel R, Penzkofer T, Kim MS, Balzer M, Borggrefe J, Meyer HJ, Surov A (2025)

Publication Type: Journal article

Publication year: 2025

Journal

Clinical Imaging Elsevier

Book Volume: 117

Article Number: 110303

DOI: 10.1016/j.clinimag.2024.110303

Abstract

Purpose: This study evaluates the prognostic significance of pleural effusion (PE) in COVID-19 patients across thirteen centers in Germany, aiming to clarify its role in predicting clinical outcomes. Methods: In this retrospective analysis within the RACOON project (Radiological Cooperative Network of the COVID-19 pandemic), 1183 patients (29.3 % women, 70.7 % men) underwent chest CT to assess PE. We investigated PE's association with 30-day mortality, ICU admission, and the need for mechanical ventilation. Results: PE was detected in 31.5 % of patients, showing a significant correlation with 30-day mortality (47.5 % in non-survivors vs. 27.3 % in survivors, p < 0.001), with a hazard ratio of 2.22 (95 % CI 1.65–2.99, p < 0.001). No significant association was found between PE volume or density and mortality. ICU admissions were noted in 46.8 % of patients, while mechanical ventilation was required for 26.7 %. Conclusion: Pleural effusion is present in a significant portion of COVID-19 patients and independently predicts increased 30-day mortality, underscoring its value as a prognostic marker. Its identification, irrespective of volume or density, should be a priority in radiological reports to guide clinical decision-making.

Authors with CRIS profile

Matthias May Institute of Radiology Lisa Siegler Institute of Radiology

Involved external institutions

Charité - Universitätsmedizin Berlin DE Germany (DE) Universitätsklinikum Leipzig DE Germany (DE) Universitätsklinikum Essen DE Germany (DE) Johannes Wesling Klinikum Minden DE Germany (DE) Universitätsklinikum Frankfurt am Main (KGU) DE Germany (DE) Universitätsmedizin der Johannes Gutenberg-Universität Mainz DE Germany (DE) Universitätsklinikum Halle (Saale) DE Germany (DE) Universitätsklinikum Schleswig-Holstein (UKSH) DE Germany (DE) Universitätsklinikum Aachen (UKA) DE Germany (DE) Universitätsklinikum Heidelberg DE Germany (DE) Universitätsklinikum Magdeburg A.ö.R. DE Germany (DE) Universitätsmedizin Rostock DE Germany (DE)

How to cite

APA:

Bucher, A.M., Dietz, J., Ehrengut, C., Müller, L., Schramm, D., Akinina, A.,... Surov, A. (2025). The prognostic relevance of pleural effusion in patients with COVID-19 - A German multicenter study. Clinical Imaging, 117. https://doi.org/10.1016/j.clinimag.2024.110303

MLA:

Bucher, Andreas Michael, et al. "The prognostic relevance of pleural effusion in patients with COVID-19 - A German multicenter study." Clinical Imaging 117 (2025).

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