tetano
Editor, Senior Moderator
Mayo Clin Proc Innov Qual Outcomes
. 2022 Jul 21.
doi: 10.1016/j.mayocpiqo.2022.07.001. Online ahead of print.
Pulmonary artery enlargement: an independent risk factor for mortality in hospitalized COVID-19 patients
Anis Ismail[SUP] 1 [/SUP], Moussa Riachy[SUP] 2 [/SUP], Mohamad Awali[SUP] 3 [/SUP], Fadi Farah[SUP] 3 [/SUP], Sarah Haddad[SUP] 1 [/SUP], Anthony Kerbage[SUP] 1 [/SUP], Noel Aoun[SUP] 3 [/SUP], Ghassan Sleilaty[SUP] 4 [/SUP]
Affiliations
Abstract
Objective: To assess whether baseline pulmonary artery diameter (PAD), obtained from Non-contrast non-gated computed tomography (NCCT), can be associated with COVID-19 outcomes.
Patients and methods: This is a retrospective study of hospitalized COVID-19 patients admitted to Hôtel-Dieu de France university hospital (Beirut, Lebanon) between March 2020 and March 2021. PAD was measured on baseline NCCT. Various outcomes were assessed, including hospital length of stay, ICU admission, invasive mechanical ventilation, mortality, and post-covid functional scale (PCFS) status at discharge and at 2-month follow-up.
Results: 465 patients had a baseline NCCT, including 315 males (67.7%) with a mean age of 63.7±16 years. Baseline PAD was higher in critically ill patients admitted to the ICU (mean difference 0.8 mm [95% CI 0.4-1.59 mm]) and those receiving invasive mechanical ventilation (mean difference 1.1 mm [95% CI 0.11-2.04 mm]). PAD at baseline correlated significantly with hospital length of stay (r = 0.130, p=0.005), discharge status (r=0.117, p=0.023) and with PCFS at 2-month follow-up (r=0.121, p=0.021). Moreover, multivariable logistic regression showed that a PAD ≥ 24.5 mm independently predicted in-hospital all-cause mortality remained unaffected in COVID-19 patients (OR 2.07 (95% CI 1.05 - 4.09)).
Conclusion: Baseline PAD measurement using NCCT can be a useful prognostic parameter. Its measurement can help identify early severe cases and adapt the initial management of hospitalized Covid-19 patients.
Keywords: COVID-19; COVID-19, Coronavirus Disease; CT-SCAN; NCCT, Non-Contrast Non-gated Computed Tomography; NEWS2, National Early Warning Score 2; PAD, Pulmonary Artery Diameter; PCFS, Post COVID-19 Functional Status; SARS-Cov-2, Severe Acute Respiratory Syndrome Coronavirus 2; mortality; post-covid functional scale (PCFS); prognostic value; pulmonary artery diameter; pulmonary hypertension.
. 2022 Jul 21.
doi: 10.1016/j.mayocpiqo.2022.07.001. Online ahead of print.
Pulmonary artery enlargement: an independent risk factor for mortality in hospitalized COVID-19 patients
Anis Ismail[SUP] 1 [/SUP], Moussa Riachy[SUP] 2 [/SUP], Mohamad Awali[SUP] 3 [/SUP], Fadi Farah[SUP] 3 [/SUP], Sarah Haddad[SUP] 1 [/SUP], Anthony Kerbage[SUP] 1 [/SUP], Noel Aoun[SUP] 3 [/SUP], Ghassan Sleilaty[SUP] 4 [/SUP]
Affiliations
- PMID: 35880237
- PMCID: PMC9300717
- DOI: 10.1016/j.mayocpiqo.2022.07.001
Abstract
Objective: To assess whether baseline pulmonary artery diameter (PAD), obtained from Non-contrast non-gated computed tomography (NCCT), can be associated with COVID-19 outcomes.
Patients and methods: This is a retrospective study of hospitalized COVID-19 patients admitted to Hôtel-Dieu de France university hospital (Beirut, Lebanon) between March 2020 and March 2021. PAD was measured on baseline NCCT. Various outcomes were assessed, including hospital length of stay, ICU admission, invasive mechanical ventilation, mortality, and post-covid functional scale (PCFS) status at discharge and at 2-month follow-up.
Results: 465 patients had a baseline NCCT, including 315 males (67.7%) with a mean age of 63.7±16 years. Baseline PAD was higher in critically ill patients admitted to the ICU (mean difference 0.8 mm [95% CI 0.4-1.59 mm]) and those receiving invasive mechanical ventilation (mean difference 1.1 mm [95% CI 0.11-2.04 mm]). PAD at baseline correlated significantly with hospital length of stay (r = 0.130, p=0.005), discharge status (r=0.117, p=0.023) and with PCFS at 2-month follow-up (r=0.121, p=0.021). Moreover, multivariable logistic regression showed that a PAD ≥ 24.5 mm independently predicted in-hospital all-cause mortality remained unaffected in COVID-19 patients (OR 2.07 (95% CI 1.05 - 4.09)).
Conclusion: Baseline PAD measurement using NCCT can be a useful prognostic parameter. Its measurement can help identify early severe cases and adapt the initial management of hospitalized Covid-19 patients.
Keywords: COVID-19; COVID-19, Coronavirus Disease; CT-SCAN; NCCT, Non-Contrast Non-gated Computed Tomography; NEWS2, National Early Warning Score 2; PAD, Pulmonary Artery Diameter; PCFS, Post COVID-19 Functional Status; SARS-Cov-2, Severe Acute Respiratory Syndrome Coronavirus 2; mortality; post-covid functional scale (PCFS); prognostic value; pulmonary artery diameter; pulmonary hypertension.