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Pulmonary vascular enlargement and lesion extent on computed tomography are correlated with COVID-19 disease severity

Authors
  • Aoki, Ryo1, 2
  • Iwasawa, Tae1, 2
  • Hagiwara, Eri1
  • Komatsu, Shigeru1
  • Utsunomiya, Daisuke1, 2
  • Ogura, Takashi1
  • 1 Kanagawa Cardiovascular and Respiratory Center, 6-16-1 Tomioka-higashi, Kanazawa-ku, Yokohama, Kanagawa, 236-8651, Japan , Yokohama (Japan)
  • 2 Yokohama City University, 3 Chome-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan , Yokohama (Japan)
Type
Published Article
Journal
Japanese Journal of Radiology
Publisher
Springer Singapore
Publication Date
Jan 27, 2021
Volume
39
Issue
5
Pages
451–458
Identifiers
DOI: 10.1007/s11604-020-01085-2
Source
Springer Nature
Keywords
License
Yellow

Abstract

PurposeTo assess the relationships among pulmonary vascular enlargement, computed tomography (CT) findings quantified with software, and coronavirus disease (COVID-19) severity.Materials and methodsUltra-high-resolution (UHR) CT images of 87 patients (50 males, 37 females; median age, 63 years) with COVID-19 confirmed using real-time polymerase chain reaction were analyzed. The maximum subsegmental vascular diameter was measured on CT. Total CT lung volume (CTLV total) and lesion extent (ratio of lesion volume to CTLV total) of ground-glass opacities, reticulation, and consolidation were measured using software. Maximum pulmonary vascular diameter and lesion extent were analyzed using Spearman’s correlation analysis. Logistic regression analysis was performed on CT results to predict disease severity. We also assessed changes in these measures on follow-up scans in 16 patients.ResultsAll 23 patients with severe and critical illness had vascular enlargement (> 4 mm). Pulmonary vascular enlargement (odds ratio 3.05, p = 0.018) and CT lesion extent (odds ratio 1.07, p = 0.002) were independent predictors of disease severity after adjustment for age and comorbidities. On follow-up CT, vascular diameter and CT lesion volume decreased (p = 0.001, p = 0.002; respectively), but CTLV total did not change significantly.ConclusionSubsegmental vascular enlargement is a notable finding to predict acute COVID-19 disease severity.

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