Chest CT–derived pulmonary artery enlargement at the admission predicts overall survival in COVID-19 patients: insight from 1461 consecutive patients in Italy
| العنوان: | Chest CT–derived pulmonary artery enlargement at the admission predicts overall survival in COVID-19 patients: insight from 1461 consecutive patients in Italy |
|---|---|
| المؤلفون: | Alberto Monello, Gianluigi Patelli, Tommaso Nannini, Gianmarco Iannopollo, Antonio Esposito, Francesco De Cobelli, Anna Palmisano, Piergiorgio Turchio, Giovanni Landoni, Chiara Gnasso, Gianluca Pontone, Luisa Di Mare, Carlo Tacchetti, Clelia Di Serio, Antonio Colombo, Sandro Sironi, Marco Loffi, Fabio Ciceri, Andrea Biagi, Elisabetta Mancini, Daniele Andreini, Riccardo Leone, Pietro Sergio, Alberto Zangrillo, Giacomo Monti, Gianni Casella, Paola M.V. Rancoita, Alberto Cereda, Davide Vignale, Guglielmo Gallone, Francesco Giannini, Valeria Nicoletti, Davide Ippolito, Marco Toselli |
| المساهمون: | Esposito, A, Palmisano, A, Toselli, M, Vignale, D, Cereda, A, Rancoita, P, Leone, R, Nicoletti, V, Gnasso, C, Monello, A, Biagi, A, Turchio, P, Landoni, G, Gallone, G, Monti, G, Casella, G, Iannopollo, G, Nannini, T, Patelli, G, Di Mare, L, Loffi, M, Sergio, P, Ippolito, D, Sironi, S, Pontone, G, Andreini, D, Mancini, E, Di Serio, C, De Cobelli, F, Ciceri, F, Zangrillo, A, Colombo, A, Tacchetti, C, Giannini, F, Esposito, Antonio, Palmisano, Anna, Toselli, Marco, Vignale, Davide, Cereda, Alberto, Rancoita, Paola Maria Vittoria, Leone, Riccardo, Nicoletti, Valeria, Gnasso, Chiara, Monello, Alberto, Biagi, Andrea, Turchio, Piergiorgio, Landoni, Giovanni, Gallone, Guglielmo, Monti, Giacomo, Casella, Gianni, Iannopollo, Gianmarco, Nannini, Tommaso, Patelli, Gianluigi, Di Mare, Luisa, Loffi, Marco, Sergio, Pietro, Ippolito, Davide, Sironi, Sandro, Pontone, Gianluca, Andreini, Daniele, Mancini, Elisabetta Maria, Di Serio, Clelia, De Cobelli, Francesco, Ciceri, Fabio, Zangrillo, Alberto, Colombo, Antonio, Tacchetti, Carlo, Giannini, Francesco |
| المصدر: | European Radiology |
| بيانات النشر: | Springer Science and Business Media LLC, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Male, Thorax, medicine.medical_specialty, 030204 cardiovascular system & hematology, 030218 nuclear medicine & medical imaging, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine.artery, Humans, Medicine, Radiology, Nuclear Medicine and imaging, Lung volumes, Aged, Retrospective Studies, medicine.diagnostic_test, SARS-CoV-2, business.industry, Tomography, X-ray computed, Hazard ratio, COVID-19, Interventional radiology, General Medicine, medicine.disease, Pulmonary hypertension, Pulmonary artery, Pneumonia, Italy, Hypertension, pulmonary, Radiology Nuclear Medicine and imaging, Chest, Female, Radiology, business, Cohort study |
| الوصف: | Objectives Enlarged main pulmonary artery diameter (MPAD) resulted to be associated with pulmonary hypertension and mortality in a non-COVID-19 setting. The aim was to investigate and validate the association between MPAD enlargement and overall survival in COVID-19 patients. Methods This is a cohort study on 1469 consecutive COVID-19 patients submitted to chest CT within 72 h from admission in seven tertiary level hospitals in Northern Italy, between March 1 and April 20, 2020. Derivation cohort (n = 761) included patients from the first three participating hospitals; validation cohort (n = 633) included patients from the remaining hospitals. CT images were centrally analyzed in a core-lab blinded to clinical data. The prognostic value of MPAD on overall survival was evaluated at adjusted and multivariable Cox’s regression analysis on the derivation cohort. The final multivariable model was tested on the validation cohort. Results In the derivation cohort, the median age was 69 (IQR, 58–77) years and 537 (70.6%) were males. In the validation cohort, the median age was 69 (IQR, 59–77) years with 421 (66.5%) males. Enlarged MPAD (≥ 31 mm) was a predictor of mortality at adjusted (hazard ratio, HR [95%CI]: 1.741 [1.253–2.418], p p = 0.005), together with male gender, old age, high creatinine, low well-aerated lung volume, and high pneumonia extension (c-index [95%CI] = 0.826 [0.796–0.851]). Model discrimination was confirmed on the validation cohort (c-index [95%CI] = 0.789 [0.758–0.823]), also using CT measurements from a second reader (c-index [95%CI] = 0.790 [0.753;0.825]). Conclusion Enlarged MPAD (≥ 31 mm) at admitting chest CT is an independent predictor of mortality in COVID-19. Key Points •Enlargement of main pulmonary artery diameter at chest CT performed within 72 h from the admission was associated with a higher rate of in-hospital mortality in COVID-19 patients. •Enlargement of main pulmonary artery diameter (≥ 31 mm) was an independent predictor of death in COVID-19 patients at adjusted and multivariable regression analysis. •The combined evaluation of clinical findings, lung CT features, and main pulmonary artery diameter may be useful for risk stratification in COVID-19 patients. |
| تدمد: | 1432-1084 0938-7994 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::77a3fc00004757428a7d787e00baa85cTest https://doi.org/10.1007/s00330-020-07622-xTest |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....77a3fc00004757428a7d787e00baa85c |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14321084 09387994 |
|---|