Online ISSN: 2515-8260

Pulmonary Computed Tomography Hallmarks and the Short-term Outcome of COVID-19 Pneumonia in Patients with an Underlying Cardiovascular Disease

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Nahid Rezaeian 1 , Parham Rabiei 1 , Shirin Manshouri 2 , Leila Hosseini 1, 3, Yaser Toloueitabar 4 , Marzieh Motevalli 1 , Hamidreza Pouraliakbar 1 , Leila Shayan 5 , Sanaz Asadian 1

Abstract

The reference laboratory examination for the diagnosis of coronavirus disease 2019 (COVID-19) is the reverse transcription-polymerase chain reaction (RT-PCR) test; nonetheless, given its false-negative results, chest computed tomography (CT) is deemed a worthier method. We aimed to define the chest CT characteristics of patients with COVID-19 who suffered from an underlying cardiovascular disease (CVD) and determine the correlation between short-term clinical outcomes and imaging features. Results: Our retrospective cross-sectional study registered 36 patients with definitive COVID‐19 pneumonia suffered from an underlying CVD. For all the patients, imaging and laboratory evaluations were done within 3 to 6 days from symptom onset. Imaging and lab findings and short-term clinical outcomes were recorded and analyzed. In our population (mean age of 51.22 ± 20.59 years), 20 (55.6%) patients improved and 16 (44.4%) expired. The most frequent pulmonary parenchymal patterns were groundglass opacity (GGO) (97.2%, 35/36), pulmonary arterial focal dilatation (72.2%, 26/36), consolidation (63.9%, 23 /36), and bronchial wall thickening (63.9%, 23/36). The mortality rate was higher in the presence of the crazy-paving pattern (72.7%, 8 /11), multilobar lung disease (53.8%, 14/26), and lobar pulmonary involvement (100%, 5/5) (all Ps < 0.05). The median of the total severity score (TSS) was higher in the non-surviving patients (P = 0.06). Conclusions: The most common CT features were GGO, pulmonary arterial focal dilatation, consolidation, and bronchial wall thickening. The crazy-paving pattern, multilobar involvement, lobar pneumonia, higher TSS, and also particular CT characteristics in CVD cases with anemia and lymphopenia were significant indicators of mortality.

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