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. 2022 Oct;6(5):399-408.
doi: 10.1016/j.mayocpiqo.2022.07.001. Epub 2022 Jul 21.

Pulmonary Artery Enlargement: An Independent Risk Factor for Mortality in Patients Hospitalized With COVID-19

Moussa A Riachy  1 , Anis Ismail  2 , Mohamad Awali  3 , Fadi Farah  3 , Sara F Haddad  2 , Anthony Kerbage  2 , Noel Aoun  3 , Ghassan Sleilaty  4
Affiliations

Pulmonary Artery Enlargement: An Independent Risk Factor for Mortality in Patients Hospitalized With COVID-19

Moussa A Riachy et al. Mayo Clin Proc Innov Qual Outcomes. 2022 Oct.

Abstract

Objective: To assess whether baseline pulmonary artery diameter (PAD), obtained from noncontrast nongated computed tomography (NCCT), can be associated with coronavirus disease 2019 (COVID-19) outcomes.

Patients and methods: This is a retrospective study of patients hospitalized with COVID-19 admitted to Hôtel-Dieu de France university hospital (Beirut, Lebanon) between March 1, 2020 and March 1, 2021. Pulmonary artery diameter was measured at baseline NCCT. Various outcomes were assessed, including hospital length of stay, intensive care unit admission, invasive mechanical ventilation, mortality, and Post-COVID-19 Functional Status scale at discharge and at 2-month follow-up.

Results: Four hundred sixty-five patients underwent baseline NCCT, including 315 men (67.7%) with a mean age of 63.7±16 years. Baseline PAD was higher in critically ill patients admitted to the intensive care unit (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). Pulmonary artery diameter at baseline correlated significantly with hospital length of stay (r=0.130; P=.005), discharge status (r=0.117; P=.023), and with Post-COVID-19 Functional Status scale at 2-month follow-up (r=0.121; P=.021). Moreover, multivariable logistic regression showed that a PAD of 24.5 mm and above independently predicted in-hospital all-cause mortality remained unaffected in patients with COVID-19 (odds ratio, 2.07; 95% CI, 1.05-4.09).

Conclusion: Baseline PAD measurement using NCCT can be a useful prognostic parameter. Its measurement can help to identify early severe cases and adapt the initial management of patients hospitalized with COVID-19.

Keywords: COVID-19, coronavirus disease; NCCT, noncontrast nongated 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.

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Figure
Measurement of pulmonary artery diameter using noncontrast nongated computed tomography.
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