Department of Radiology, Malatya Training and Research Hospital, Malatya, Turkey.
Eur Rev Med Pharmacol Sci. 2021 Jul;25(14):4835-4840. doi: 10.26355/eurrev_202107_26397.
Coronavirus disease-2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) follows a biphasic disease model consisting of an early viral response phase and an inflammation phase. SARS-CoV-2 has a high affinity for the upper respiratory tract and conjunctiva; hence, it can infect the upper respiratory tract and facilitate airway inflammation. COVID-19 also affects the tracheal epithelial cells. We hypothesized that the size of the trachea increases depending on the severity of the disease, and this increase is an indicator of poor prognosis. There are no studies on this subject in literature, to the best of our knowledge. For this purpose, in this study, the tracheas of 326 patients who reported to the radiology clinic were examined by evaluating the thoracic computed tomography (CT) images.
The patients who were admitted to the Malatya Training and Research Hospital between September and December 2020, had a positive SARS-CoV-2 nasopharyngeal reverse transcription-polymerase chain reaction result, and had undergone thoracic CT, were included in the study. The thoracic CT scans without respiratory artifacts were evaluated, and anteroposterior (AP) and transverse diameters of the trachea were measured at the thyroid and bifurcation levels.
We believe that a tracheal AP diameter of >20 mm at the thyroid level and a tracheal AP diameter of 18 mm at the thyroid bifurcation level (according to Group 3 and Group 4) may be indicators of poor prognosis. In terms of survival, a tracheal AP diameter of >18 mm at the bifurcation level can be considered as a poor prognostic factor.
The tracheal diameter may increase in proportion to the severity of inflammation, indicating or accompanying a poor prognosis. Patients with extensive involvement should be monitored closely for the development of tracheal stenosis.
由严重急性呼吸系统综合征冠状病毒 2 型（SARS-CoV-2）引起的 2019 年冠状病毒病（COVID-19）遵循双相疾病模式，包括早期病毒反应相和炎症相。SARS-CoV-2 对上呼吸道和结膜具有高亲和力；因此，它可以感染上呼吸道并促进气道炎症。COVID-19 还会影响气管上皮细胞。我们假设气管的大小会随着疾病的严重程度而增加，并且这种增加是预后不良的指标。据我们所知，目前尚无关于该主题的文献研究。为此，在这项研究中，通过评估胸部计算机断层扫描（CT）图像，对 326 名因 COVID-19 报告至放射科诊所的患者的气管进行了检查。
本研究纳入了 2020 年 9 月至 12 月期间在马拉蒂亚培训与研究医院住院、SARS-CoV-2 鼻咽部逆转录-聚合酶链反应结果阳性、并接受了胸部 CT 检查的患者。评估无呼吸伪影的胸部 CT 扫描，并在甲状腺和分叉水平测量气管的前后（AP）和横向直径。
我们认为甲状腺水平的气管 AP 直径>20 毫米和甲状腺分叉水平的气管 AP 直径 18 毫米（根据第 3 组和第 4 组）可能是预后不良的指标。就生存而言，气管分叉水平的 AP 直径>18 毫米可被视为预后不良的因素。
气管直径可能会随着炎症的严重程度而增加，表明或伴有预后不良。广泛受累的患者应密切监测气管狭窄的发展。
