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 mm² relative to the total pulmonary blood volume (BV5%) on chest computed tomography (CT) in COVID-19 patients is predictive of adverse clinical outcomes.

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.

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.

The data suggest BV5% as a novel biomarker for predicting adverse outcomes in patients with COVID-19 seeking acute medical care.

有证据表明，血管炎症和血栓形成可能是导致 COVID-19 患者临床结果不佳的重要驱动因素。我们假设，在 COVID-19 患者胸部计算机断层扫描 (CT) 上，横截面积在 1.25 至 5 mm ²之间的血管中的血容量相对于肺总血容量 (BV5%) 的百分比显着下降预测不良临床结果。

我们对美国两个州 10 家医院的 313 名 COVID-19 阳性和 195 名寻求紧急医疗护理的 COVID-19 阴性患者的胸部 CT 扫描进行了回顾性分析。

BV5% 可预测多变量模型中 COVID-19 患者的结局，BV5% 阈值低于 25% 与死亡率 OR 5.58 相关，与插管相关 OR 3.20 相关，与死亡率或插管综合相关 OR 2.54 相关。使用年龄和 BV5% 的模型的受试者工作特征曲线下面积为 0.85，用于预测 COVID-19 患者的死亡率或插管的综合情况。 BV5% 不能预测未患 COVID-19 的患者的临床结果。

数据表明，BV5% 可作为一种新型生物标志物，用于预测寻求紧急医疗护理的 COVID-19 患者的不良后果。