To assess pulmonary vascular metrics on chest CT of COVID-19 patients, and their correlation with pneumonia extent (PnE) and outcome, we analyzed COVID-19 patients with an available previous chest CT, excluding those performed for cardiovascular disease. From February 21 to March 21, 2020, of 672 suspected COVID-19 patients from two centers who underwent CT, 45 RT-PCR-positives (28 males, median age 75, IQR 66-81 years) with previous CTs performed a median 36 months before (IQR 12-72 months) were included. We assessed PnE, pulmonary artery (PA) diameter, ascending aorta (Ao) diameter, and PA/Ao ratio. Most common presentations were fever and dyspnea (15/45) and fever alone (13/45). Outcome was available for 41/45 patients, 15/41 dead and 26/41 discharged. Ground-glass opacities (GGOs) alone were found in 29/45 patients, GGOs with consolidations in 15/45, consolidations alone in 1/45. All but one patient had bilateral pneumonia, 9/45 minimal, 22/45 mild, 9/45 moderate, and 5/45 severe PnE. PA diameter (median 31 mm, IQR 28-33 mm) was larger than before (26 mm, IQR 25-29 mm) (P<0.001), PA/Ao ratio (median 0.83, IQR 0.76-0.92) was higher than before (0.76, IQR 0.72-0.82) (P<0.001). Patients with adverse outcome (death) had higher PA diameter (P=0.001), compared to discharged ones. Only weak correlations were found between Delta PA or Delta PA/Ao and PnE (rho <= 0.453, P <= 0.032), with 4/45 cases with moderate-severe PnE and minimal increase in PA metrics. In conclusion, enlarged PA diameter was associated to death in COVID-19 patients, a finding deserving further investigation as a potential driver of therapy decision-making.
CT-derived pulmonary vascular metrics and clinical outcome in COVID-19 patients / P. Spagnolo, A. Cozzi, R.A. Foà, A. Spinazzola, L. Monfardini, C. Bnà, M. Alì, S. Schiaffino, F. Sardanelli. - In: QUANTITATIVE IMAGING IN MEDICINE AND SURGERY. - ISSN 2223-4292. - 10:6(2020 Jun), pp. 1325-1333.
|Titolo:||CT-derived pulmonary vascular metrics and clinical outcome in COVID-19 patients|
COZZI, ANDREA (Co-primo)
FOA', RICCARDO ALESSANDRO (Secondo)
SARDANELLI, FRANCESCO (Ultimo)
|Parole Chiave:||tomography; X-ray Computed; COVID-19; hypertension; pulmonary; pneumonia; viral; SARS-CoV-2; patient outcome assessment;|
|Settore Scientifico Disciplinare:||Settore MED/36 - Diagnostica per Immagini e Radioterapia|
|Data di pubblicazione:||giu-2020|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.21037/qims-20-546|
|Appare nelle tipologie:||01 - Articolo su periodico|
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