Inferior vena cava and pulmonary artery diameters for prognosis of Coronavirus disease

Abstract

Aim: In this study, we aimed to analyze the relationship between pulmonary artery (PA) and inferior vena cava (IVC) diameters in non-contrast chest computerized tomography (CT) images of patients with coronavirus disease 2019 (COVID-19) and overall survival.

Material and Methods: This retrospective study consisted of 404 consecutive patients who underwent chest CT after admission to the emergency department between May 1 and June 31. 2021. CT measurements were performed by two radiologists. The prognostic value of PA and IVC diameters, the computerized tomography severity score (CT-55), quick sequential organ failure assessment (qSOFA), and confusion, urea, respiratory rate, blood pressure, and age >= years (CURB-65) score on overall survival were examined.

Results: The median age of the participants was 62 years (49-72), and 196 (48.5%) were male. Of the 404 patients, 61 died after admission. While main-PA, left-PA, right-PA (p < 0.001) and NC-transverse (IVC-Tr) (p = 0.045) diameters were larger and statistically significant in the patients who died (AUC; 0.686, 0.722, 0.746, and 0.581, respectively), a statistically significant difference was not detected in terms of IVC anteroposterior diameter (IVC-AP) (p = 0.053) and the IVC-Tr/AP (p = 0.754) ratio. There was a statistical difference in mortality in ciSOFA, CURB-65, and CT-SS values (AUC; 0.727, 0.798, and 0.708 p < 0.001, respectively).

Discussion: PA diameters measured from chest CT images at admission (main-PA >= 26.5 mm, right-PA >= 22.9 mm, and left-PA >= 21.6 mm) and the IVC-Tr diameter (>= 34.5 mm) can be used as mortality predictors for COVID-19, along with other prognostic scores.