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Lung CT Segmentation to Identify Consolidations and Ground Glass Areas for Quantitative Assesment of SARS-CoV Pneumonia
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Prognostic utility of pulmonary artery and ascending aorta diameters derived from computed tomography in COVID-19

Mehmet Erdoğan1, Selçuk Öztürk2, Mehmet Akif Erdöl3

  • 1Department of Cardiology, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey.

Echocardiography (Mount Kisco, N.Y.)
|August 6, 2021
PubMed

Insights

Pulmonary artery enlargement, measured by main pulmonary artery diameter (MPA) on chest CT scans, is a strong predictor of in-hospital mortality in COVID-19 patients. This easily calculated metric aids in patient prognostication.

Area of Science:

  • Radiology
  • Cardiology
  • Infectious Diseases

Background:

  • Chest computed tomography (CT) is crucial for diagnosing and predicting outcomes in Coronavirus disease 2019 (COVID-19).
  • Identifying reliable imaging biomarkers for in-hospital mortality in COVID-19 patients is essential for clinical management.

Purpose of the Study:

  • To evaluate the predictive capability of main pulmonary artery diameter (MPA), ascending aorta diameter (AAo), and their ratio for in-hospital mortality in COVID-19 patients.
  • To compare the prognostic value of these cardiovascular CT measurements.

Main Methods:

  • Retrospective analysis of 255 hospitalized severe or critical COVID-19 patients.
  • Measurement of MPA and AAo from transverse axial CT images at the pulmonary artery bifurcation and maximal aortic diameter, respectively.
  • Calculation of the MPA-to-AAo ratio and statistical analysis using logistic and Cox regression models.

Main Results:

  • Multivariate logistic regression identified MPA ≥29.15 mm and MPA itself as independent predictors of in-hospital mortality (p < 0.001).
  • Ascending aorta diameter (AAo) was also a significant predictor (p = 0.040), while the MPA-to-AAo ratio showed borderline significance (p = 0.001).
  • Time-dependent Cox regression confirmed MPA ≥29.15 mm (p = 0.047) and MPA (p = 0.048) as independent predictors, with AAo and the ratio not reaching statistical significance.

Conclusions:

  • Pulmonary artery enlargement, indicated by MPA, is a strong predictor of in-hospital mortality in COVID-19 patients.
  • MPA, readily obtainable from chest CT, offers a valuable tool for prognostication in these patients.
  • Further research may explore the clinical utility of MPA in guiding COVID-19 patient management.
Abstract

Keywords:
COVID-19ascending aortacomputed tomographypulmonary artery

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