COVID-19: What Can Iodine Maps From Perfusion CT Teach Us? A Prospective Cohort Study

Background: Subtraction CT angiography (sCTA) is a technique used to evaluate pulmonary perfusion based on iodine distribution maps. The aim of this study is to assess lung perfusion changes with sCTA seen in patients with COVID-19 pneumonia and correlate them with clinical outcomes. Material and Me...

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Bibliographic Details
Published in:Critical Care 2020
Main Authors: Santamarina, Mario G, Riscal, Dominique Boisier, Beddings, Ignacio, Contreras, Roberto, Baque, Martiniano, Volpacchio, Mariano, Felipe Martinez Lomakin
Format: Text Resource
Language:English
Subjects:
Coronaviruses
COVID-19
Iodine
Severe acute respiratory syndrome coronavirus 2
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Summary:Background: Subtraction CT angiography (sCTA) is a technique used to evaluate pulmonary perfusion based on iodine distribution maps. The aim of this study is to assess lung perfusion changes with sCTA seen in patients with COVID-19 pneumonia and correlate them with clinical outcomes. Material and Methods: A prospective cohort study was carried out with 45 RT-PCR-confirmed COVID-19 patients that required hospitalization at three different hospitals, between April and May 2020. In all cases, a basic clinical and demographic profile was obtained. Lung perfusion was assessed using sCTA. Evaluated imaging features included: Pattern predominance of injured lung parenchyma in both lungs (ground-glass opacities, consolidation and mixed pattern) and anatomical extension; predominant type of perfusion abnormality (increased perfusion or hypoperfusion), perfusion abnormality distribution (focal or diffuse), extension of perfusion abnormalities (mild, moderate and severe involvement); presence of vascular dilatation and vascular tortuosity. All participants were followed-up until hospital discharge searching for the development of any of the study endpoints. These endpoints included intensive-care unit (ICU) admission, initiation of invasive mechanical ventilation (IMV) and death. Results: Forty-one patients (55.2 +/- 16.5 years, 22 men) with RT-PCR-confirmed SARS-CoV-2 infection and an interpretable iodine map were included. Patients with perfusion anomalies on sCTA in morphologically normal lung parenchyma showed lower Pa/Fi values (294 ± 111.3 vs. 397 ± 37.7, p=0.035), and higher D-dimer levels (1156 ± 1018 vs. 378 ± 60.2, p
DOI:10.21203/rs.3.rs-52422/v2