Do CT-derived pulmonary vascular indices correlate with the severity of pneumonia in COVID-19 patients?
Enlarged pulmonary artery diameter and increased PA/AO ratio on unenhanced chest CT are associated with severe COVID-19 pneumonia, potentially serving as early markers for pulmonary hemodynamics alteration.
Context: The currently on-going COVID-19 pandemic resulted in the abnormal lung parenchymal changes which can also alter pulmonary vascular hemodynamics. Aims: This study was aimed to assess CT derived pulmonary vascular indices in COVID 19 patients in different groups based on the extent of pneumonia using CT severity score. Settings and design: Retrospective study at COVID-19 care centre in central India. Methods and material: This study included 78 institutionalized patients who were confirmed COVID-19 positive status. All patients were assessed based on demographic data, CT severity score; CT derived pulmonary vascular indices such as main pulmonary artery diameter and the pulmonary artery to aorta ratio (PA/AO). Changes in these pulmonary vascular indices were determined in each mild, moderate and severe group of pneumonia. Results: Out of 78 patients, 25.6% patients belonged to mild group, 28.2% belonged to moderate group and 21.8% belonged to severe group. 70.5% of all patients were males and 29.5% were females. 11% males and 17.4% females showed increased pulmonary artery above normal limits. 4 males and 4 females with increased pulmonary artery diameter belonged to severe group of COVID 19 pneumonia while 8 out of 10 patients with increased PA/AO belonged to severe group of pneumonia extent. Conclusions: In this study, patients with pulmonary artery enlargement and increased PA/AO (PA/AO) were predominantly found to belong to severe group of COVID-19 pneumonia, a finding requiring further investigation which will help to predict pulmonary hypertension in COVID 19 patients which has an unfavourable outcome.
Dhok et al. (Fri,) studied this question.