Department of Ultrasound, Jiading Branch of Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, 800 Huangjiahuayuan Road, Jiading District, Shanghai, 201803, China.
Department of Ultrasound, Guanghua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200052, China.
BMC Infect Dis. 2024 Oct 21;24(1):1183. doi: 10.1186/s12879-024-10091-y.
COVID-19 viral pneumonia can result in increased arterial stiffness, along with cardiac and systemic inflammatory responses. This study aimed to investigate the association between arterial stiffness, inflammation severity, and all-cause mortality in patients with COVID-19.
In this study, anthropometric data, pneumonia infection severity, and blood tests were analyzed. Arterial stiffness was assessed using the non-invasive assessment indices, including arterial velocity pulse index (AVI) and central arterial pulse pressure (CAPP). Infection volumes and percentages for the whole lungs, most lobes, and most segments were extracted from CT images using artificial intelligence-based quantitative analysis software. The relationship between arterial stiffness, central hemodynamics, and all-cause mortality was investigated.
In multivariable Cox regression analysis, high CAPP was significantly associated with all-cause mortality (hazard ratio: 0.263, 95% CI, 0.073-0.945, p = 0.041). Whole lung infection percentages were independently associated with high CAPP, with an area under the curve (AUC) of 0.662 and a specificity of 89.09%.
High CAPP, but not high AVI, demonstrated independent prognostic value for all-cause mortality in patients due to COVID-19 pneumonia infection. Evaluating this parameter could help in risk assessment and improve diagnostic and therapeutic strategies in viral pneumonia infections.
COVID-19 病毒性肺炎可导致动脉僵硬，以及心脏和全身炎症反应。本研究旨在探讨 COVID-19 患者动脉僵硬与炎症严重程度和全因死亡率之间的关系。
本研究分析了人体测量数据、肺炎感染严重程度和血液检查。使用基于人工智能的定量分析软件从 CT 图像中提取整个肺部、大多数肺叶和大多数肺段的感染体积和百分比。研究了动脉僵硬、中心血流动力学和全因死亡率之间的关系。
多变量 Cox 回归分析显示，高 CAPP 与全因死亡率显著相关（危险比：0.263，95%CI，0.073-0.945，p=0.041）。全肺感染百分比与高 CAPP 独立相关，曲线下面积（AUC）为 0.662，特异性为 89.09%。
高 CAPP（而非高 AVI）可独立预测 COVID-19 肺炎感染患者的全因死亡率。评估该参数有助于评估风险，并改善病毒性肺炎感染的诊断和治疗策略。
