Investigation of morphometric properties of intrathoracic structures on mortality in COVID-19 patients

Covid-19 disease is a human disease caused by a new type of virus belonging to the coronavirus family, which was detected in the Wuhan region of China in late 2019. Since this disease is highly contagious, it has spread rapidly and has been declared a pandemic. The virus can affect the lungs in some patients and can be fatal. While most people suffer from mild outpatient illness, which does not require hospitalization, some people unfortunately have to be treated inpatients, need intensive care during this process and even die. It is reported that some patient groups are more susceptible to the virus. The gold standard in the diagnosis of the disease is the demonstration of the virus, as well as thorax tomography imaging and blood tests are also very important. In this study, two groups, living and deceased, were determined, and the parameters that may have an effect on mortality between these groups were examined. The study was conducted on a total of 147 deceased and 175 living cases, which were investigated retrospectively. Demographic data, tomography images and blood results of the patients were recorded. Age, gender, cardiovascular system disease, chronic lung disease, diabetes, kidney failure, liver failure, and comorbidities of the cases were evaluated. As blood parameters, white blood cell, neutrophil, lymphocyte, NLR (neutrophil lymphocyte ratio), thrombocyte, ALT, AST, LDH, CRP, D-Dimer, INR and fibrinogen values were measured. Total lung volumes were measured using the Slicer application on tomography imaging. Using the RadiAnt program, trachea transverse diameter, trachea anteroposterior diameter and their ratio, tracheal index, heart transverse diameter, thorax transverse diameter and their ratio, cardiothoracic ratio, pulmonary artery diameter, right pulmonary artery diameter, left pulmonary artery diameter, ascending aorta diameter, and the ratio of the of the pulmonary artery diameter to the of the ascending aorta diameter was measured. All the parameters obtained were analyzed and it was checked whether they were significant between the deceased and the living. It was found that advanced age, male gender and having cardiovascular system disease, chronic lung disease and kidney failure showed poor prognosis. An increase in white blood cell, neutrophil, AST, LDH, CRP, D-Dimer, INR and NLR parameters and a decrease in lymphocyte values indicated a poor prognosis. Considering all cases, regardless of gender, it was determined that a decrease in total lung volumes, an increase in trachea anteroposterior diameter, an increase in left pulmonary artery and right pulmonary artery diameters indicated xix a poor prognosis. When the cases were divided into groups as female and male, lung volumes were found to be significant in the same way. While no other significant parameter was found in men, the increase in left pulmonary artery diameter, increase in right pulmonary artery diameter, increase in thorax transverse diameter and increase in cardiothoracic ratio in women were found to be significant. In the light of these findings, it is possible to have an idea about which patients may be mortal by looking at some parameters through the examinations to be made at the time of the first admission to the hospital. With these parameters to be considered, the treatment programs of the patients can be shaped differently. Keywords: Covid-19, Mortality, Lung volume, Morphometry, Tomography, Slicer