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Published on: December 19, 2020
Carotid Body Size on CT Angiography in Patients With COVID-19 Pneumonia
Kamber Goksu1, Ahmet Vural1, Ahmet Nedim Kahraman1
1Department of Radiology, University of Health Sciences Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Türkiye.
Purpose:
Many pathophysiological theories have been expressed regarding increased sympathetic activity along with respiratory failure in patients with COVID-19 pneumonia. In addition, the carotid bodies, which are directly related to increased blood oxygen levels and sympathetic activity, are known to be very rich in the angiotensin-converting enzyme 2 (ACE2) receptor, which the COVID-19 causative virus uses to enter the cell. Therefore, the probability of carotid bodies being affected in patients with COVID-19 pneumonia is quite high. Carotid bodies can be visualized with contrast-enhanced CT angiography (CTA), and we aimed to visualize possible carotid body enlargement in COVID-19 patients with CTA.
Methods:
We retrospectively evaluated patients who were hospitalized for COVID-19 pneumonia during the pandemic in our hospital and who had CTA examinations at least 3 months after treatment. We drew a Region of Interest (ROI) from the periphery of both carotid bodies and measured the area from the widest part. Similarly, measurements were taken in the control group without a history of COVID-19, and the results of the two groups were compared statistically.
Results:
We performed measurements on CTA images of 104 control subjects and 108 patients. The total carotid body area of the patients with COVID-19 pneumonia was 4.9 ± 3.7 mm2, and the carotid body area of the control group was 3.7 ± 2.4 mm2. In comparing the two groups, the carotid body area was found to be statistically significantly larger (p < 0.05) in patients with COVID-19 pneumonia.
Conclusion:
The size of the carotid body was found to be larger in patients with COVID-19 pneumonia compared to the control group. This finding may indicate conditions that lead to the activation of carotid body chemo and baroreceptors, such as increased sympathetic activity and a decrease in blood oxygen pressure in patients with COVID-19 pneumonia. Apart from this, it may also be possible for the carotid body to be directly infected with the virus. More specific studies that shed light on this aspect are needed.
