ABSTRACT
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.
ABSTRACT
INTRODUCTION: Pulmonary hypertension (PH) is a threatening condition, and it is far more common than previously assumed, especially after the COVID pandemic. Its outcome is not good; if detected late, and can lead to right ventricular failure, which can be fatal. Our goal was to evaluate CT signs of PH, correlate them with echocardiography, and identify the cut-off values of these signs in our population. METHOD: In this study, 160 patients having both CT and echocardiography with a maximum gap of one month were assessed from June to November 2021. The association between CT signs and echocardiography to diagnose PH was investigated. The Pearson and Spearman correlation and area under receiver operating curve (AUROC) tests were performed in the analysis. Receiver operating characteristic curve analysis was also used to assess CT's diagnostic capability and cut-off values. RESULT: The correlation between main pulmonary artery (MPA) diameter and main pulmonary artery to aorta ratio (MPA/AO) with mean pulmonary artery pressure (mPAP) was weak but statistically significant (r = 0.316 and r = 0.321, p<0.001). However, there was a very weak correlation between the right and left pulmonary artery and mPAP with correlation coefficients (r) of 0.155 and 0.138, respectively. For the first time in our population, we measured the cut-off values of MPA and MPA/AO ratios for PH which were 26 and 0.88 mm, respectively. CONCLUSIONS: The CT signs of PH correlate with echocardiography; however, should not be used solely; the cut-off values should be used according to race and population.