Prognostic importance of pulmonary artery measurement in patients with COVID-19 and correlation with computed tomography severity score

Prognostic importance of pulmonary artery measurement in patients with COVID-19 and correlation with computed tomography severity score

Aim: To evaluate is the relationship of enlarged main pulmonary artery (mPA) diameter in COVID-19 with disease severity and early term prognosis by using computed tomography severity score (CTSS). Materials and Methods: 906 of 1650 COVID-19 patients with chest computed tomography (CT) included in the study. The patient groups were divided in two as short (≤7 day) and long ( > 7 day) hospitalization according to the length of hospital stay. The patients who were admitted to the intensive care unit (ICU) and those who died were also recorded. We assessed CTSS and PA diameter on CT images. Results: 540 (60%) patients had pneumonia. 291 (54%) of them were found to have pure ground glass opacity (GGO), 168 (31%) of them were found to have both GGO and consolidation, 60 (11%) of them were found to have consolidation and 21 (4%) of them were found to have crazy paving pattern. There was a significant correlation between PA diameter and hospitalization time (r:0.339; p < 0.001), intensive care unit (ICU) need and mortality (r:0.398, 0.326; respectively; p < 0.001). There was a significant correlation between PA increase and CTTS increase (r:0.226; p = 0.002). The area under the curve of the mPA in predicting patient mortality was 0.805 (95% CI:0.695–0.915). The best cut-off value of mPA was taken as 28,4 sensitivity and specificity was found 78.9%, 74.5% respectively. CTSS of the cases who died because of COVID-19 were significantly higher (p = 0.023). The area under the ROC curve of CTSS in predicting patient mortality was 0.668 (95% CI:0.554-0.781). The best cut off value of CTSS was taken as 13 sensitivity and specificity was found 57.8%, 80.9% respectively. Conclusion: mPA diameter increase is associated with poor prognosis including long term hospitalization, ICU hospitalization and mortality in COVID-19 cases.

___

  • 1. World Health Organization. Pneumonia of unknown cause: China. www.who.int/csr/don/05-january-2020-pneumonia-ofunkown-cause-china/en/. Accessed February 13th, 2020
  • 2. Ye Z, Zhang Y, Wang Y, Huang Z, Song B. Chest CT manifestations of new coronavirus disease 2019 (COVID-19): a pictorial review. Eur Radiol. 2020 Aug;30(8):4381-4389. doi: 10.1007/s00330-020-06801-0. Epub 2020 Mar 19. PMID: 32193638; PMCID: PMC7088323.
  • 3. Huang C, Wang Y, Li X et al. Clinical features of patientsinfected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395:497-506.
  • 4. Aslan S, Bekci T, Cakir IM et al. "Diagnostic performance of low-dose chest CT to detect COVID-19: A Turkish population study." Diag and Interv Radiol 2020 Sep 2. [Epub Ahead of Print]
  • 5. Hoeper MM, Ghofrani HA, Grünig E et al. "Pulmonary hypertension." Dtsch Arztebl Int 2017; 114:73-84.
  • 6. Boerrigter B, Mauritz GJ, Marcus JT et al. Progressive dilatation of the main pulmonary artery is a characteristic of pulmonary arterial hypertension and is not related to changes in pressure. Chest 2010; 138:1395–1401.
  • 7. Lewis G, Hoey ETD, Reynolds JH, et al. Multi-detector CT assessment in pulmonary hypertension: techniques, systematic approach to interpretation and key findings. Quant Imaging Med Surg 2015; 5:423-432.
  • 8. Truong QA, Massaro JM, Rogers IS et al. Reference Values for Normal Pulmonary Artery Dimensions by Noncontrast Cardiac Computed Tomography. Circ Cardiovasc Imaging 2012; 5:147- 154.
  • 9. Lechowicz K, Drożdżal S, Machaj F, Rosik J, Szostak B, ZeganBarańska M, Biernawska J, Dabrowski W, Rotter I, Kotfis K. COVID-19: The Potential Treatment of Pulmonary Fibrosis Associated with SARS-CoV-2 Infection. J Clin Med. 2020 Jun 19;9(6):1917.
  • 10. Yildiz M, Yadigar S, Yildiz BŞ, Aladag NB, Keskin O, Ozer RS, Topel C, Kahraman S. Evaluation of the relationship between COVID-19 pneumonia severity and pulmonary artery diameter measurement. Herz. 2021 Feb;46(1):56-62.
  • 11. Pan F, Ye T, Sun P et al. "Time course of lung changes on chest CT during recovery from 2019 novel coronavirus (COVID-19) pneumonia." Radiology 2020; 295:715-721
  • 12. Murphy ML, Dinh H, Nicholson D. Chronic cor pulmonale. Dis Mon 1989; 35:653–718
  • 13. Price LC, McAuley DF, Marino PS et al. "Pathophysiology of pulmonary hypertension in acute lung injury." Am J Physiol Lung Cell and Mol Physiol 2012; 302:803-815.
  • 14. Wells JM, Washko GR, Han MK et al. "Pulmonary arterial enlargement and acute exacerbations of COPD." N Engl J Med 2012; 367:913-921.
  • 15. Shen Y, Wan C, Tian P et al. "CT-Base Pulmonary Artery Measurementin the Detection of Pulmonary Hypertension: A MetaAnalysis and Systematic Review." Medicine 2014; 93:e256
  • 16. Pagnesi M, Baldetti L, Beneduce A et al. "Pulmonary hypertension and right ventricular involvement in hospitalised patients with COVID-19." Heart 2020; 106:1324-1331.
  • 17. Beiderlinden M, Kuehl H, Boes T et al. Prevalence of pulmonary hypertension associated with severe acute respiratory distress syndrome: Predictive value of computed tomography. Intensive Care Med 2006; 32:852-857.
  • 18. Raoufi M, Safavi Naini SAA, Azizan Z et al. "Correlation between Chest Computed Tomography Scan Findings and Mortality of COVID-19 Cases; a Cross sectional Study." Arch Acad Emerg Med 2020; 8:e57.
  • 19. Spagnolo P, Cozzi A, Foà RA et al. "CT-derived pulmonary vascular metrics and clinical outcome in COVID-19 patients." Quant Imaging Med and Surg 2020; 10:1325-1333.
  • 20. Yuan M, Yin W, Tao Z et al. Association of radiologic findings with mortality of patients infected with 2019 novel coronavirus in Wuhan, China. PloS One 2020; 15:e0230548.
Annals of Medical Research-Cover
  • Yayın Aralığı: Aylık
  • Yayıncı: İnönü Üniversitesi Tıp Fakültesi
Sayıdaki Diğer Makaleler

Wrist arthroscopy: Is it really effective for all common wrist disorders?

Orçun ŞAHİN

The effect of perioperative nutritional therapy on the cognitive functions and nutritional status in elderly patients with femoral neck fracture

Ahmet ŞEN, Mücahit TAFLAN, Başar ERDİVANLI

Does arteriovenous fistula operation cause neuropathy in upper extremity? An EMG study

Mehmet KIZILAY, Abdinafic Mohamud HUSSEIN, Bektaş KORKMAZ

Economical and easy methods of smoke stain removal from maxillofacial prostheses

Meral KURT, Nuran ÖZYEMİŞÇİ

Bullous dermatosis in the southeastern of Turkey: A study of 125 cases

İrem YANATMA, Gülbahar SARAÇ, Hülya CENK, Hacer VURAL KARATOPRAK

Investigation of the potential beneficial effects of fish oil against methotrexate-induced brain injury

Kürşat KAYA, Ali GÜLER, Volkan İPEK

Mutation profile of the patients diagnosed with myeloid neoplasia tested with next generation sequencing and clinical implications

Akif AYAZ, Yaşa Gül MUTLU, Fatma SECA, Berrin BALIK AYDIN, Ömür Gökmen SEVİNDİK

Etiological findings in cases with incidental liver metastasis and factors affecting survival

Fatma TERZİOĞLU ŞAHİN, Yasin Furkan ÇAĞIN

Investigation of herpes simplex virus type 2 seroprevalence in all age groups

Ayfer BAKIR, Sema ALACAM, Mustafa GÜNEY, Mehmet Tevfik YAVUZ

Prognostic importance of pulmonary artery measurement in patients with COVID-19 and correlation with computed tomography severity score

Serdar ASLAN, İsmet Miraç ÇAKIR, İskender AKSOY, Alptekin TOSUN, Tumay BEKÇİ, Erdem YÜZÜAK, Ömer GÖRGEL, Ahmet Cumhur DÜLGER, Selda GÜNAYDIN, Hayriye BEKTAŞ AKSOY, Ahmet Melih ŞAHİN, Emsal AYDIN