Riachy Moussa A, Ismail Anis, Awali Mohamad, Farah Fadi, Haddad Sara F, Kerbage Anthony, Aoun Noel, Sleilaty Ghassan
Division of Pulmonary and critical care medicine, Hôtel Dieu de France Hospital, Beirut, Lebanon.
Faculty of Medicine, Saint Joseph University of Beirut, Lebanon.
Mayo Clin Proc Innov Qual Outcomes. 2022 Oct;6(5):399-408. doi: 10.1016/j.mayocpiqo.2022.07.001. Epub 2022 Jul 21.
To assess whether baseline pulmonary artery diameter (PAD), obtained from noncontrast nongated computed tomography (NCCT), can be associated with coronavirus disease 2019 (COVID-19) outcomes.
This is a retrospective study of patients hospitalized with COVID-19 admitted to Hôtel-Dieu de France university hospital (Beirut, Lebanon) between March 1, 2020 and March 1, 2021. Pulmonary artery diameter was measured at baseline NCCT. Various outcomes were assessed, including hospital length of stay, intensive care unit admission, invasive mechanical ventilation, mortality, and Post-COVID-19 Functional Status scale at discharge and at 2-month follow-up.
Four hundred sixty-five patients underwent baseline NCCT, including 315 men (67.7%) with a mean age of 63.7±16 years. Baseline PAD was higher in critically ill patients admitted to the intensive care unit (mean difference, 0.8 mm; 95% CI, 0.4-1.59 mm) and those receiving invasive mechanical ventilation (mean difference, 1.1 mm; 95% CI, 0.11-2.04 mm). Pulmonary artery diameter at baseline correlated significantly with hospital length of stay (=0.130; =.005), discharge status (=0.117; =.023), and with Post-COVID-19 Functional Status scale at 2-month follow-up (=0.121; =.021). Moreover, multivariable logistic regression showed that a PAD of 24.5 mm and above independently predicted in-hospital all-cause mortality remained unaffected in patients with COVID-19 (odds ratio, 2.07; 95% CI, 1.05-4.09).
Baseline PAD measurement using NCCT can be a useful prognostic parameter. Its measurement can help to identify early severe cases and adapt the initial management of patients hospitalized with COVID-19.
评估从非增强非门控计算机断层扫描（NCCT）获得的基线肺动脉直径（PAD）是否与2019冠状病毒病（COVID-19）的预后相关。
这是一项对2020年3月1日至2021年3月1日期间入住法国迪厄医院大学医院（黎巴嫩贝鲁特）的COVID-19住院患者的回顾性研究。在基线NCCT上测量肺动脉直径。评估了各种预后指标，包括住院时间、重症监护病房入住情况、有创机械通气、死亡率以及出院时和2个月随访时的COVID-19后功能状态量表。
465例患者接受了基线NCCT检查，其中315例男性（67.7%），平均年龄63.7±16岁。入住重症监护病房的危重症患者（平均差异0.8mm；95%CI，0.4 - 1.59mm）和接受有创机械通气的患者（平均差异1.1mm；95%CI，0.11 - 2.04mm）的基线PAD更高。基线时的肺动脉直径与住院时间显著相关（r = 0.130；P = 0.005）、出院状态（r = 0.117；P = 0.023）以及2个月随访时的COVID-19后功能状态量表显著相关（r = 0.121；P = 0.021）。此外，多变量逻辑回归显示，PAD为24.5mm及以上独立预测COVID-19患者的院内全因死亡率（比值比，2.07；95%CI，1.05 - 4.09）。
使用NCCT测量基线PAD可能是一个有用的预后参数。其测量有助于早期识别重症病例并调整COVID-19住院患者最初的治疗方案。
