Altered pulmonary blood volume distribution as a biomarker for predicting outcomes in COVID-19 disease. Issue 3 (16th September 2021)

• Record Type: Journal Article
• Authors: Morris, Michael F.; Pershad, Yash; Kang, Paul; Ridenour, Lauren; Lavon, Ben; Lanclus, Maarten; Godon, Rik; De Backer, Jan; Glassberg, Marilyn K.
• Is Part Of: European respiratory journal. Volume 58:Issue 3(2021)
• Publication Date: 2021-09-16
• Subjects: Respiratory organs -- Diseases -- Periodicals; Respiration -- Periodicals; 616.2
• DOI: 10.1183/13993003.04133-2020
• Languages: English
• ISSNs: 0903-1936

Abstract

Introduction: Evidence suggests that vascular inflammation and thrombosis may be important drivers of poor clinical outcomes in patients with COVID-19. We hypothesised that a significant decrease in the percentage of blood volume in vessels with a cross-sectional area between 1.25 and 5 mm 2 relative to the total pulmonary blood volume (BV5%) on chest computed tomography (CT) in COVID-19 patients is predictive of adverse clinical outcomes. Methods: We performed a retrospective analysis of chest CT scans from 10 hospitals across two US states in 313 COVID-19-positive and 195 COVID-19-negative patients seeking acute medical care. Results: BV5% was predictive of outcomes in COVID-19 patients in a multivariate model, with a BV5% threshold below 25% associated with OR 5.58 for mortality, OR 3.20 for intubation and OR 2.54 for the composite of mortality or intubation. A model using age and BV5% had an area under the receiver operating characteristic curve of 0.85 to predict the composite of mortality or intubation in COVID-19 patients. BV5% was not predictive of clinical outcomes in patients without COVID-19. Conclusions: The data suggest BV5% as a novel biomarker for predicting adverse outcomes in patients with COVID-19 seeking acute medical care. BV5% derived from chest CT may serve as an imaging biomarker for predicting adverse outcomes in patients with COVID-19 seeking acute medical care https://bit.ly/2Zg18Vv