Association with changes in pulmonary artery diameters and outcomes in COVID-19: Retrospective study

Abstract

ABSTRACT

Background: It is known that mortality is increased in enlarged pulmonary artery diameter (PAD) in COVID-19. It is unknown whether the change in PAD occurs before COVID-19

Aim: To find the factors that affect changes in PAD; the relationship between the PAD and radiological scores, clinical outcomes in COVID-19 patients.

Methods: In this retrospective, and single center study, among the 3264 patients hospitalized between March 2020 and June 2021, 209 patients with previous chest CT were included. Current PADs obtained during COVID-19 were compared with previous chest CTs. Pulmonary involvement, WHO Clinical Progression Scale and laboratory variables have been recorded from the hospital information system. ICU admission, intubation, and mortality were clinical outcomes evaluated by using uni- and multivariate analysis.

Results: High D-dimer had significantly increased risk for enlarged PAD (OR=1.2), increased PAD compared to previous Chest CT (OR=1.18). Both high D-dimer and at least 2 mm increase in PAD significantly increased the risk for ICU admission, intubation, and mortality. (OR= 1.18, OR=1.22, OR=2.62, OR=2.12, OR=2.32, OR=2.09 respectively). Combined with age and lymphocyte count, PAD predicted mortality (50% sensitivity, 88% specificity, AUC=0.83, p<0.001).

Conclusion: Patients with increased PAD of at least 2 mm have increased significantly clinical severity, ICU admission, intubation, and mortality. This study showed, first time, that is risk of ICU admission. High D-dimer and inflammation markers suggest that increased inflammation and thrombosis may play a crucial role in pathogenesis.