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Altered pulmonary blood volume distribution as a biomarker for predicting outcomes in COVID-19 disease
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) relati...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
European Respiratory Society
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7908189/ https://www.ncbi.nlm.nih.gov/pubmed/33632795 http://dx.doi.org/10.1183/13993003.04133-2020 |
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author | Morris, Michael F. Pershad, Yash Kang, Paul Ridenour, Lauren Lavon, Ben Lanclus, Maarten Godon, Rik De Backer, Jan Glassberg, Marilyn K. |
author_facet | Morris, Michael F. Pershad, Yash Kang, Paul Ridenour, Lauren Lavon, Ben Lanclus, Maarten Godon, Rik De Backer, Jan Glassberg, Marilyn K. |
author_sort | Morris, Michael F. |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-7908189 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | European Respiratory Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-79081892021-02-26 Altered pulmonary blood volume distribution as a biomarker for predicting outcomes in COVID-19 disease Morris, Michael F. Pershad, Yash Kang, Paul Ridenour, Lauren Lavon, Ben Lanclus, Maarten Godon, Rik De Backer, Jan Glassberg, Marilyn K. Eur Respir J Original Research Articles 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. European Respiratory Society 2021-09-16 /pmc/articles/PMC7908189/ /pubmed/33632795 http://dx.doi.org/10.1183/13993003.04133-2020 Text en Copyright ©The authors 2021. https://creativecommons.org/licenses/by-nc/4.0/This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions@ersnet.org (mailto:permissions@ersnet.org) |
spellingShingle | Original Research Articles Morris, Michael F. Pershad, Yash Kang, Paul Ridenour, Lauren Lavon, Ben Lanclus, Maarten Godon, Rik De Backer, Jan Glassberg, Marilyn K. Altered pulmonary blood volume distribution as a biomarker for predicting outcomes in COVID-19 disease |
title | Altered pulmonary blood volume distribution as a biomarker for predicting outcomes in COVID-19 disease |
title_full | Altered pulmonary blood volume distribution as a biomarker for predicting outcomes in COVID-19 disease |
title_fullStr | Altered pulmonary blood volume distribution as a biomarker for predicting outcomes in COVID-19 disease |
title_full_unstemmed | Altered pulmonary blood volume distribution as a biomarker for predicting outcomes in COVID-19 disease |
title_short | Altered pulmonary blood volume distribution as a biomarker for predicting outcomes in COVID-19 disease |
title_sort | altered pulmonary blood volume distribution as a biomarker for predicting outcomes in covid-19 disease |
topic | Original Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7908189/ https://www.ncbi.nlm.nih.gov/pubmed/33632795 http://dx.doi.org/10.1183/13993003.04133-2020 |
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