Key result
Severe pulmonary involvement on chest CT in COVID-19 patients was significantly associated with a higher rate of abnormal pulmonary artery to ascending aorta ratio (>1) compared to mild or moderate involvement (63.6% vs 29.2% and 35.9%, p=0.018).
Why the study?
Cardiovascular complications including pulmonary arterial abnormalities have been emphasized in COVID-19, prompting evaluation of the relationship between pulmonary infection severity and the pulmonary artery to aorta ratio on chest CT.
Does the severity of pulmonary involvement in COVID-19 correlate with an abnormal PA/AA ratio on chest CT?
Cross-Sectional (n=74)
Blinded observers
No
Does the severity of pulmonary involvement in COVID-19 correlate with an abnormal PA/AA ratio on chest CT?
Absolute Event Rate: 63.6% vs 29.2%
p-value: p=0.018
In patients with COVID-19, an abnormal PA/AA ratio (>1) on unenhanced chest CT is significantly associated with more severe pulmonary involvement, suggesting its potential utility as a prognostic radiological marker.
May signal severe COVID-19 involvement on routine CT; leaves open prospective validation as a prognostic marker.
Background. Majority of patients infected with coronavirus disease 2019 (COVID-19) present with an acute respiratory illness of varying severity. Chest computerized tomography (CT) is one of the important steps in the diagnostic work-up of pulmonary involvement. Cardiovascular complications including pulmonary arterial (PA) abnormalities have been recently emphasized upon. This study aims to evaluate the relationship between severity of pulmonary infection and pulmonary artery/aorta (PA/AA) ratio on chest CT scan. Material and Methods. This cross section study was conducted on 74 patients with confirmed diagnosis of COVID-19 who underwent chest CT scans.. Radiologists assessed every CT examination and graded the extent of pulmonary involvement and severity score obtained. The diameters of PA and aorta were measured and PA/AA ratio was then calculated. Results. Among 74 patients, 28 patients have abnormal PA/AA ration (>1) . Twenty four patients (32.2%) were classified as mild, 39 (52.7%) as moderate and 11 (14.8%) as severe, with statistically significant difference regarding presence of abnormal PA/AA ratio (P> 0.05) specially in patients with severe pulmonary involvement. There was no significant difference regarding gender and age groups. There was no statistically significant relationship between PA/AA ratio and pattern of pulmonary radiological findings. Conclusion. Covid-19 patients with severe pulmonary involvement (higher severity score) tend to have abnormal PA/AA ratio. PA /A ratio could be used as an additional prognostic radiological marker in assessment of Covid-19 infection.
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Al-Tameemi et al. (2023) conducted a cross-sectional in COVID-19 infection (n=74). Severe pulmonary involvement on chest CT vs. Mild or moderate pulmonary involvement was evaluated on Abnormal pulmonary artery to ascending aorta (PA/AA) ratio (>1) (p=0.018). Severe pulmonary involvement on chest CT in COVID-19 patients was significantly associated with a higher rate of abnormal pulmonary artery to ascending aorta ratio (>1) compared to mild or moderate involvement (63.6% vs 29.2% and 35.9%, p=0.018).
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