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Published on: December 19, 2020
Pulmonary artery diameter and NT-proBNP in patients with Covid-19: Predicting prognosis and mortality
Mercan Tastemur1, Esin Olcucuoğlu2, Gunes Arik1
1Ministry of Health, Ankara City Hospital, Department of Geriatrics Medicine.
Insights
High NT-proBNP levels and an elevated main pulmonary artery diameter to ascending aorta diameter ratio are independent predictors of mortality in COVID-19 patients. These findings aid in assessing prognosis and guiding clinical decisions for severe cases.
Area of Science:
- Cardiology
- Radiology
- Infectious Diseases
Background:
- COVID-19 presents with diverse clinical manifestations, complicating prognosis assessment.
- Key factors influencing COVID-19 mortality remain incompletely understood.
Purpose of the Study:
- To investigate the association between N-terminal pro B-type natriuretic peptide (NT-proBNP) and main pulmonary artery diameter (MPAD) with COVID-19 prognosis and mortality.
- To identify independent risk factors for mortality in COVID-19 patients.
Main Methods:
- Retrospective analysis of 152 adult COVID-19 patients.
- Evaluation of thoracic CT scans, NT-proBNP levels, laboratory, and demographic data.
- Multivariate logistic regression analysis to determine independent risk factors.
Main Results:
- High NT-proBNP levels (OR=3.542) and MPAD/ascending aortic diameter (AAD) ratio > 0.75 (OR=2.692) were independent predictors of mortality.
- Significant positive correlation found between NT-proBNP and MPAD (r=0.296, p<0.001).
- Identified cut-off values: MPAD 27.5 mm and NT-proBNP 742 pg/ml.
Conclusions:
- Thoracic CT-derived MPAD/AAD ratio and NT-proBNP levels are significant independent risk factors for predicting mortality in COVID-19.
- Integrating radiological and laboratory data is crucial for accurate prognosis assessment in COVID-19.
- These biomarkers can aid clinicians in stratifying risk and managing patients.
Background:
The diverse and complex presentations of COVID-19 continue to impact the world. Factors related to prognosis and mortality are still not fully illuminated.
Objectives:
We aimed to asses the relationship of N-terminal pro B-type natriuretic peptide (NT-proBNP) and main pulmonary artery diameter (MPAD) with COVID-19 prognosis and mortality.
Methods:
152 COVID-19 patients over the age of 18, were included in the study. Thoracic CT, NT-proBNP values, laboratory and demographic data of these patients were obtained by retrospectively examining the patient files and scanning the results through the patient registry.
Results:
According to multivariate logistic regression (LR) analysis, high NT-proBNP level (OR=3.542; 95% CI=1.745-9.463; p=0.021) and MPAD/ascending aortic diameter (AAD) ratio>0.75 (OR=2.692; 95% CI=1.264-9.312; p=0.036) were determined as independent risk factors predicting mortality in COVID-19 patients. A significant positive correlation was observed between NT-proBNP level and MPA diameter (r=0.296, p<0.001). The cut-off value was measured as 27.5 mm for MPA diameter and 742 pg/ml for NT-proBNP.
Conclusions:
Accurate and effective interpretation of available radiological and laboratory data is essential to reveal the factors predicting prognosis and mortality in COVID-19. In this study,we evaluated that the thorax CTs and determined that the MPAD/AAD and NT-proBNP level were independent risk factors in predicting mortality.
