Pulmonary artery trunk enlargement on admission as a predictor of mortality in in-hospital patients with COVID-19

Purpose To describe the prognostic value of pulmonary artery (PA) trunk enlargement on the admission of in-hospital patients with severe COVID-19 infection by unenhanced CT image. Materials and methods In-hospital patients confirmed COVID-19 from January 18, 2020, to March 7, 2020, were retrospectively enrolled. PA trunk diameters on admission and death events were collected to calculate the optimum cutoff using a receiver operating characteristic curve. According to the cutoff, the subjects on admission were divided into two groups. Then the in-hospital various parameters were compared between the two groups to assess the predictive value of PA trunk diameter. Results In the 180 enrolled in-hospital patients (46.99 +/- 14.95 years; 93 (51.7%) female, 14 patients (7.8%) died during their hospitalization. The optimum cutoff PA trunk diameter to predict in-hospital mortality was > 29 mm with a sensitivity of 92.59% and a specificity of 91.11%. Kaplan-Meier survival curves for PA trunk diameter on admission showed that a PA trunk diameter > 29 mm was a significant predictor of subsequent death (log-rank < 0.001, median survival time of PA > 29 mm was 28 days). Conclusion PA trunk enlargement can be a useful predictive factor for distinguishing between mild and severe COVID-19 disease progression.

Automated summary

The study suggests that a pulmonary artery trunk diameter greater than 29mm upon admission can serve as a significant predictor of in-hospital mortality for COVID-19 patients, potentially useful for distinguishing disease progression severity.