Altered Pulmonary Blood Volume Distribution As a Biomarker for Predicting Outcomes in COVID-19 Disease

Overview

Journal Eur Respir J

Specialty Pulmonary Medicine

Date 2021 Feb 26

PMID 33632795

Citations 23

Authors

Michael F Morris

Yash Pershad

Paul Kang

Lauren Ridenour

Ben Lavon

Maarten Lanclus

Rik Godon

Jan De Backer

Marilyn K Glassberg

Affiliations

Soon will be listed here.

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 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.

Citing Articles

U-Net-based computed tomography quantification of viral pneumonia can predict fibrotic interstitial lung abnormalities at 3-month follow-up.

Ying Z, Zhu Z, Hu G, Pan Z, Tan W, Han W Front Med (Lausanne). 2024; 11:1435337.

PMID: 39403283 PMC: 11471527. DOI: 10.3389/fmed.2024.1435337.

Oscillometry Longitudinal Data on COVID-19 Acute Respiratory Syndrome Treated with Non-Invasive Respiratory Support.

Torregiani C, Baratella E, Segalotti A, Ruaro B, Salton F, Confalonieri P J Clin Med. 2024; 13(7).

PMID: 38610633 PMC: 11012861. DOI: 10.3390/jcm13071868.

Sialylated Glycan Bindings from SARS-CoV-2 Spike Protein to Blood and Endothelial Cells Govern the Severe Morbidities of COVID-19.

Scheim D, Vottero P, Santin A, Hirsh A Int J Mol Sci. 2023; 24(23).

PMID: 38069362 PMC: 10871123. DOI: 10.3390/ijms242317039.

Quantitative Analysis for Lung Disease on Thin-Section CT.

Iwasawa T, Matsushita S, Hirayama M, Baba T, Ogura T Diagnostics (Basel). 2023; 13(18).

PMID: 37761355 PMC: 10528918. DOI: 10.3390/diagnostics13182988.

Unraveling pathophysiologic mechanisms contributing to symptoms in patients with post-acute sequelae of COVID-19 (PASC): A retrospective study.

Dierckx W, De Backer W, Ides K, De Meyer Y, Lauwers E, Franck E Physiol Rep. 2023; 11(12):e15754.

PMID: 37344757 PMC: 10284821. DOI: 10.14814/phy2.15754.

References

Wiersinga W, Rhodes A, Cheng A, Peacock S, Prescott H . Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19): A Review. JAMA. 2020; 324(8):782-793. DOI: 10.1001/jama.2020.12839. View

Vahidy F, Drews A, Masud F, Schwartz R, Askary B, Boom M . Characteristics and Outcomes of COVID-19 Patients During Initial Peak and Resurgence in the Houston Metropolitan Area. JAMA. 2020; 324(10):998-1000. PMC: 7426882. DOI: 10.1001/jama.2020.15301. View

Synn A, Li W, San Jose Estepar R, Washko G, OConnor G, Tsao C . Pulmonary Vascular Pruning on Computed Tomography and Risk of Death in the Framingham Heart Study. Am J Respir Crit Care Med. 2020; 203(2):251-254. PMC: 7874407. DOI: 10.1164/rccm.202005-1671LE. View

Lang M, Som A, Carey D, Reid N, Mendoza D, Flores E . Pulmonary Vascular Manifestations of COVID-19 Pneumonia. Radiol Cardiothorac Imaging. 2021; 2(3):e200277. PMC: 7307217. DOI: 10.1148/ryct.2020200277. View

Francone M, Iafrate F, Masci G, Coco S, Cilia F, Manganaro L . Chest CT score in COVID-19 patients: correlation with disease severity and short-term prognosis. Eur Radiol. 2020; 30(12):6808-6817. PMC: 7334627. DOI: 10.1007/s00330-020-07033-y. View

Homayounieh F, Ebrahimian S, Babaei R, Karimi Mobin H, Zhang E, Bizzo B . CT Radiomics, Radiologists, and Clinical Information in Predicting Outcome of Patients with COVID-19 Pneumonia. Radiol Cardiothorac Imaging. 2021; 2(4):e200322. PMC: 7380121. DOI: 10.1148/ryct.2020200322. View

Polak S, Van Gool I, Cohen D, von der Thusen J, van Paassen J . A systematic review of pathological findings in COVID-19: a pathophysiological timeline and possible mechanisms of disease progression. Mod Pathol. 2020; 33(11):2128-2138. PMC: 7306927. DOI: 10.1038/s41379-020-0603-3. View

Lins M, Vandevenne J, Thillai M, Lavon B, Lanclus M, Bonte S . Assessment of Small Pulmonary Blood Vessels in COVID-19 Patients Using HRCT. Acad Radiol. 2020; 27(10):1449-1455. PMC: 7381940. DOI: 10.1016/j.acra.2020.07.019. View

Richardson S, Hirsch J, Narasimhan M, Crawford J, McGinn T, Davidson K . Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA. 2020; 323(20):2052-2059. PMC: 7177629. DOI: 10.1001/jama.2020.6775. View

10.

Ackermann M, Verleden S, Kuehnel M, Haverich A, Welte T, Laenger F . Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in Covid-19. N Engl J Med. 2020; 383(2):120-128. PMC: 7412750. DOI: 10.1056/NEJMoa2015432. View

11.

Pershad Y, Guo M, Altman R . Pathway and network embedding methods for prioritizing psychiatric drugs. Pac Symp Biocomput. 2019; 25:671-682. PMC: 6951442. View

12.

San Jose Estepar R, Kinney G, Black-Shinn J, Bowler R, Kindlmann G, Ross J . Computed tomographic measures of pulmonary vascular morphology in smokers and their clinical implications. Am J Respir Crit Care Med. 2013; 188(2):231-9. PMC: 3778757. DOI: 10.1164/rccm.201301-0162OC. View

13.

Rahaghi F, Argemi G, Nardelli P, Dominguez-Fandos D, Arguis P, Peinado V . Pulmonary vascular density: comparison of findings on computed tomography imaging with histology. Eur Respir J. 2019; 54(2). PMC: 7007984. DOI: 10.1183/13993003.00370-2019. View

14.

Washko G, Nardelli P, Ash S, Sanchez-Ferrero G, Rahaghi F, Come C . Arterial Vascular Pruning, Right Ventricular Size, and Clinical Outcomes in Chronic Obstructive Pulmonary Disease. A Longitudinal Observational Study. Am J Respir Crit Care Med. 2019; 200(4):454-461. PMC: 6701031. DOI: 10.1164/rccm.201811-2063OC. View

15.

Zhang H, Zhou P, Wei Y, Yue H, Wang Y, Hu M . Histopathologic Changes and SARS-CoV-2 Immunostaining in the Lung of a Patient With COVID-19. Ann Intern Med. 2020; 172(9):629-632. PMC: 7081173. DOI: 10.7326/M20-0533. View

16.

Peys E, Stevens D, Vande Weygaerde Y, Malfait T, Hermie L, Rogiers P . Haemoptysis as the first presentation of COVID-19: a case report. BMC Pulm Med. 2020; 20(1):275. PMC: 7578236. DOI: 10.1186/s12890-020-01312-6. View

17.

Williamson E, Walker A, Bhaskaran K, Bacon S, Bates C, Morton C . Factors associated with COVID-19-related death using OpenSAFELY. Nature. 2020; 584(7821):430-436. PMC: 7611074. DOI: 10.1038/s41586-020-2521-4. View

18.

Thillai M, Patvardhan C, Swietlik E, McLellan T, De Backer J, Lanclus M . Functional respiratory imaging identifies redistribution of pulmonary blood flow in patients with COVID-19. Thorax. 2020; 76(2):182-184. DOI: 10.1136/thoraxjnl-2020-215395. View

19.

Cavallo J, Donoho D, Forman H . Hospital Capacity and Operations in the Coronavirus Disease 2019 (COVID-19) Pandemic-Planning for the Nth Patient. JAMA Health Forum. 2022; 1(3):e200345. DOI: 10.1001/jamahealthforum.2020.0345. View

20.

Klok F, Kruip M, van der Meer N, Arbous M, Gommers D, Kant K . Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb Res. 2020; 191:145-147. PMC: 7146714. DOI: 10.1016/j.thromres.2020.04.013. View