Measurement of Tracheobronchial Angles of COVID-19 Patients on Computed Tomography and Correlation with Pneumonia Severity in Turkish Population

ABSTRACT

Aim: This study aimed to evaluate the values of tracheobronchial angles on computed tomography (CT) and to investigate the relationship between angles and CT severity scores (CT-SS) of coronavirus disease 2019 (COVID-19) patients. There is no available literature measuring tracheobronchial angles of adult COVID-19 patients and investigating the relationship of angles with pneumonia severity. Material and Methods: This study was a single-center retrospective analysis of 92 RT-PCR positive patients, aged between 18-40 years, who underwent CT between May and October 2020. The right bronchial angles (RBA), left bronchial angles (LBA), subcarinal angles (SCA), and interbronchial angles (IBA) were measured by a radiologist on coronal CT images with the measurement model used in past. CT-SS was calculated by using a visual scoring system with a global score of 0-25. Results: Thirty-seven (40.2%) patients had normal CT imaging and 55 (59.8%) patients had pulmonary involvement. The CT-SS were ranged from 0 to 24, with a median value of 2.5. The mean IBA was calculated as 81.67±15.20°, mean SCA 77.65±15.78°, mean RBA 39.26±7.51°, and mean LBA 43.35±8.43°. No statistically significant difference was found in SCA, IBA, RBA, and LBA between the groups with and without COVID-19 pneumonia (p=0.277, p=0.389, p=0.218, and p=0.227, respectively). Also, no significant correlation was found between tracheobronchial angles and pneumonia CT-SS of the patients. Conclusion: We calculated the distribution range of tracheobronchial angle values in the adult Turkish COVID-19 patients. According to our study, tracheobronchial angles don’t affect the disease severity and clinical outcome of COVID-19 patients.