Impact of COVID-19 pneumonia on pulmonary vascular volume

Guillaume Fahrni; Ana-Carolina Rocha; Louis Gudmundsson; Chiara Pozzessere; Salah D Qanadli; David C Rotzinger

doi:10.3389/fmed.2023.1117151

Impact of COVID-19 pneumonia on pulmonary vascular volume

Front Med (Lausanne). 2023 Mar 22:10:1117151. doi: 10.3389/fmed.2023.1117151. eCollection 2023.

Authors

Guillaume Fahrni¹, Ana-Carolina Rocha¹, Louis Gudmundsson¹, Chiara Pozzessere¹, Salah D Qanadli², David C Rotzinger¹

Affiliations

¹ Cardiothoracic and Vascular Division, Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
² Riviera Chablais Hospital and University of Lausanne, Lausanne, Switzerland.

Abstract

Background: Pulmonary manifestations of COVID-19 pneumonia are well known. However, COVID-19 is also associated with a range of vascular manifestations such as embolism, congestion, and perfusion changes. Regarding congestion, research from different groups has suggested arteriovenous anastomosis dysregulation as a contributing factor. In this study, we aim to better describe the changes in vascular volume in affected lung zones and to relate them to pathophysiological hypotheses.

Methods: We performed automatic vascular volume extraction in 10 chest CTs of patients, including 2 female and 8 male with a mean age of 63.5 ± 9.3 years, diagnosed with COVID-19 pneumonia. We compared the proportion of vascular volumes between manually segmented regions of lung parenchyma with and without signs of pneumonia.

Results: The proportion of vascular volume was significantly higher in COVID (CVasc) compared to non-COVID (NCVasc) areas. We found a mean difference (DVasc) of 5% and a mean ratio (RVasc) of 3.7 between the two compartments (p < 0.01).

Conclusion: Vascular volume in COVID-19 affected lung parenchyma is augmented relative to normal lung parenchyma, indicating venous congestion and supporting the hypothesis of pre-existing intra-pulmonary arteriovenous shunts.

Keywords: COVID-19; CT; anastomoses; arteriovenous shunt; imaging; vascular volume; venous congestion.