Doğan Derya, Taşçi Cantürk, Doğan Deniz, Öcal Nesrin, Arslan Yakup, Bozlar Uğur
Clinic of Pulmonology, Etlik City Hospital, Ankara, Türkiye.
Clinic of Pulmonology, Health Sciences University Faculty of Medicine, Gülhane Education and Research Hospital, Ankara, Türkiye.
Tuberk Toraks. 2024 Jun;72(2):137-144. doi: 10.5578/tt.202402930.
This study explores the impact of vascular diameters on mortality risk in Coronavirus disease-2019 (COVID-19) patients. COVID-19, caused by severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2), presents diverse clinical manifestations and is associated with thrombosis.
In this study, we retrospectively examined the data of patients who were hospitalized and treated in our hospital between September 1, 2020, and November 30, 2020, and whose COVID-19 diagnosis was confirmed by reverse transcriptase polymerase chain reaction (RT-PCR). The diameters of the ascending aorta, main pulmonary artery, and right and left pulmonary arteries were measured from the chest computed tomography (CT) scans taken at the time of admission. The aim of the study was to investigate the impact of vascular diameters on the course of the disease.
Of 1.705 patients, 840 were eligible for the study. We concluded that 36 of the patients (4.3%) died, and among the non-survivors patients, 12 (33.3%) were females, and 24 (66.7%) were males. Hospitalization duration was 7.1 ± 3.1 vs. 6.1 ± 2 days (p= 0.004) in surviving and non-surviving patients respectively. On the other hand, we found the mean diameters of the right pulmonary artery in the chest CT of patients to be 2.17 ± 0.35 vs. 2.44 ± 0.29 cm in survivors and non-survivors, respectively (p< 0.001). In addition, we found the mean diameters of the left pulmonary artery 2.12 ± 0.32 vs. 2.34 ± 0.28 cm in survivors and non-survivors, respectively (p< 0.001). Mean diameters of the ascending aorta were 3.53 ± 0.46 vs. 3.72 ± 0.34 cm in survivors and non-survivors, respectively (p= 0.017).
The study underscores the potential prognostic value of vascular diameters, especially in the ascending aorta and main pulmonary artery, as indicators of mortality risk in COVID-19 patients. The association between vascular dilation and severity of COVID-19, coupled with elevated D-dimer levels, suggests a link between thrombosis and vascular involvement.
本研究探讨血管直径对2019冠状病毒病（COVID-19）患者死亡风险的影响。由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起的COVID-19具有多种临床表现，并与血栓形成有关。
在本研究中，我们回顾性检查了2020年9月1日至2020年11月30日期间在我院住院治疗且经逆转录聚合酶链反应（RT-PCR）确诊为COVID-19的患者的数据。从入院时拍摄的胸部计算机断层扫描（CT）中测量升主动脉、主肺动脉以及左右肺动脉的直径。本研究的目的是调查血管直径对疾病进程的影响。
在1705例患者中，840例符合研究条件。我们得出结论，36例患者（4.3%）死亡，在非幸存者中，12例（33.3%）为女性，24例（66.7%）为男性。存活患者和非存活患者的住院时间分别为7.1±3.1天和6.1±2天（p = 0.004）。另一方面，我们发现患者胸部CT中右肺动脉的平均直径在幸存者和非幸存者中分别为2.17±0.35厘米和2.44±0.29厘米（p < 0.001）。此外，我们发现左肺动脉的平均直径在幸存者和非幸存者中分别为2.12±0.32厘米和2.34±0.28厘米（p < 0.001）。升主动脉的平均直径在幸存者和非幸存者中分别为3.53±0.46厘米和3.72±0.34厘米（p = 0.017）。
该研究强调了血管直径，尤其是升主动脉和主肺动脉直径作为COVID-19患者死亡风险指标的潜在预后价值。血管扩张与COVID-19严重程度之间的关联，以及D-二聚体水平升高，提示了血栓形成与血管受累之间的联系。
