Pulmonary artery trunk enlargement on admission as a predictor of mortality in in-hospital patients with COVID-19

Jpn J Radiol. 2021 Jun;39(6):589-597. doi: 10.1007/s11604-021-01094-9. Epub 2021 Mar 22.

Abstract

Purpose: To describe the prognostic value of pulmonary artery (PA) trunk enlargement on the admission of in-hospital patients with severe COVID-19 infection by unenhanced CT image.

Materials and methods: In-hospital patients confirmed COVID-19 from January 18, 2020, to March 7, 2020, were retrospectively enrolled. PA trunk diameters on admission and death events were collected to calculate the optimum cutoff using a receiver operating characteristic curve. According to the cutoff, the subjects on admission were divided into two groups. Then the in-hospital various parameters were compared between the two groups to assess the predictive value of PA trunk diameter.

Results: In the 180 enrolled in-hospital patients (46.99 ± 14.95 years; 93 (51.7%) female, 14 patients (7.8%) died during their hospitalization. The optimum cutoff PA trunk diameter to predict in-hospital mortality was > 29 mm with a sensitivity of 92.59% and a specificity of 91.11%. Kaplan-Meier survival curves for PA trunk diameter on admission showed that a PA trunk diameter > 29 mm was a significant predictor of subsequent death (log-rank < 0.001, median survival time of PA > 29 mm was 28 days).

Conclusion: PA trunk enlargement can be a useful predictive factor for distinguishing between mild and severe COVID-19 disease progression.

Keywords: COVID-19; Death events; Pneumonia; Prognosis; Pulmonary artery trunk diameter.

MeSH terms

  • Adult
  • COVID-19 / diagnostic imaging
  • COVID-19 / mortality*
  • COVID-19 / pathology*
  • Dilatation, Pathologic / diagnostic imaging
  • Female
  • Hospital Mortality
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Pulmonary Artery / diagnostic imaging
  • Pulmonary Artery / pathology*
  • ROC Curve
  • Retrospective Studies
  • SARS-CoV-2
  • Tomography, X-Ray Computed / methods