Association between Main Pulmonary Artery Diameter and COVID-19 Severity- A Cross-sectional Study

Introduction: Long-term consequences of the Coronavirus Disease 2019 (COVID-19) pneumonia infection, like lung vessel thrombosis and pulmonary hypertension, require prompt diagnosis and management. Hence, measurement of Main Pulmonary Artery Diameter (MPAD) in patients with moderate to severe Computed Tomography (CT)-based severity scoring helps detect the possibility of complication early. In this study, Coronavirus Disease 2019 Reporting and Data System (CO-RADS) scoring for suspected patients were done. Aim: To measure MPAD in Reverse Transcription-Polymerase Chain Reaction (RT-PCR) COVID-19 positive (CO-RADS 6) and highly COVID-19 pneumonia suspicious patients (CO- RADS 4, 5) and then to associate with CT Severity Score (CTSS). Materials and Methods: This cross-sectional, retrospective study was conducted in the Department of Radiodiagnosis, Father Muller Medical College, Mangalore from January 2020 to January 2022. Total of 200 patients, including 141 males and 59 females, who were highly suspicious and positive for COVID-19 pneumonia were studied. CT findings were noted, and CTSS was calculated. This was used to categorise the study sample into mild, moderate, and severe categories. MPAD was then measured for the corresponding patients. The measurement was then associated with the COVID-19 CTSS scoring using the Chi-square test, and p-value<0.05 was considered significant. Results: Considering various parameters like age, gender, co- morbidities, and CTSS with MPAD, there was no statistically significant association between the former three parameters. Considering CTSS with MPAD, there were 72 mild, 92 moderate, and 36 severe cases. The study found a highly significant association between co-morbidities and CTSS (p-value=0.009) and a significant association between MPAD and the CTSS (p-value=0.024). Conclusion: MPAD could be used to predict the possibility of future complications like lung vessel thrombosis and pulmonary artery hypertension in patients highly suspicious and positive for COVID-19 pneumonia.