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

• Published in: Japanese journal of radiology Vol. 39; no. 6; pp. 589 - 597
• Main Authors: Zhu, Qing-Qing, Gong, Tao, Huang, Guo-Quan, Niu, Zhong-Feng, Yue, Ting, Xu, Fang-Yi, Chen, Chao, Wang, Guang-Bin
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01-06-2021; Springer Nature B.V
• Subjects: Adult; Computed tomography; Coronaviruses; COVID-19; COVID-19 - diagnostic imaging; COVID-19 - mortality; COVID-19 - pathology; Dilatation, Pathologic - diagnostic imaging; Enlargement; Female; Hospital Mortality; Hospitalization; Humans; Imaging; Male; Medical prognosis; Medicine; Medicine & Public Health; Middle Aged; Mortality; Nuclear Medicine; Original; Original Article; Prognosis; Pulmonary arteries; Pulmonary artery; Pulmonary Artery - diagnostic imaging; Pulmonary Artery - pathology; Radiology; Radiotherapy; Retrospective Studies; ROC Curve; SARS-CoV-2; Survival; Tomography, X-Ray Computed - methods; Viral diseases; COVID-19; Pulmonary artery trunk diameter; Pneumonia; Prognosis; Death events
• ISSN: 1867-1071; 1867-108X
• DOI: 10.1007/s11604-021-01094-9

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.