Pulmonary Artery To Ascending Aorta Ratio On Pulmonary Computerized Tomography In Patients With COVID-19 Infection

Abstract

Background. Majority of patients infected with coronavirus disease 2019 (COVID-19) present with an acute respiratory illness of varying severity. Chest computerized tomography (CT) is one of the important steps in the diagnostic work-up of pulmonary involvement. Cardiovascular complications including pulmonary arterial (PA) abnormalities have been recently emphasized upon. This study aims to evaluate the relationship between severity of pulmonary infection and pulmonary artery/aorta (PA/AA) ratio on chest CT scan. Material and Methods. This cross section study was conducted on 74 patients with confirmed diagnosis of COVID-19 who underwent chest CT scans.. Radiologists assessed every CT examination and graded the extent of pulmonary involvement and severity score obtained. The diameters of PA and aorta were measured and PA/AA ratio was then calculated. Results. Among 74 patients, 28 patients have abnormal PA/AA ration (>1) . Twenty four patients (32.2%) were classified as mild, 39 (52.7%) as moderate and 11 (14.8%) as severe, with  statistically significant difference regarding presence of abnormal PA/AA ratio (P> 0.05) specially in patients with severe pulmonary involvement. There was no significant difference regarding gender and age groups. There was no statistically significant relationship between PA/AA ratio  and pattern of pulmonary radiological findings.

Conclusion. Covid-19 patients with severe pulmonary involvement (higher severity score) tend to have abnormal PA/AA ratio. PA /A ratio could be used as an additional prognostic radiological marker in  assessment of Covid-19 infection.