Comparison of COVID-19 disease severity and PE rates between Kent B1.1.7 lineage versus other lineages on CTPA

Abstract

Category: ThoracicPurpose:To compare radiologically determined COVID-19 disease severity and pulmonary embolism (PE) rates on initial computed tomography pulmonary angiogram (CTPA), clinical severity and outcomes of patients infected with B1.1.7 lineage compared with those infected with remaining strains.Methods and materials:Single-centre retrospective analysis on a cohort of 139 consecutive patients with polymerase chain reaction (PCR)-confirmed COVID-19 infection who underwent CTPA and viral genome sequencing between 1 December 2020 and 7 January 2021.Two radiologists undertook blinded analysis of the first CTPA since admission and scored out of 25 for lung involvement to produce a CT severity score (CTSS). Pulmonary embolism rates were determined on radiological report. Clinical, biochemical and outcome data was collected with a median follow up of 61 days.Results:88/139 patients infected with B1.1.7 lineage.A significant difference in venous thromboembolism (VTE) rate was observed between B1.1.7 (1.1%, 1/88) and non-B1.1.7 (13.7%, 7/51) controlling for age, gender, anticoagulation on admission and comorbidities (adjusted p=0.0104).No difference in CTSS or clinical severity (determined by ventilatory requirements or oxygen saturations), hospital length of stay, admission to critical care or death between B1.1.7 and non-B1.1.7.However, significantly higher C-reactive protein (CRP) was found in non-B1.1.7 versus B1.1.7 (mean CRP 179 versus 134, adjusted p<0.0001).Conclusion:Although B1.1.7 variant has been shown to associate with increased mortality and disease severity, we did not demonstrate a difference in CT severity score nor in clinical severity or outcomes. Further, patients with non-B.1.1.7 had a significant higher rate of pulmonary embolism and higher maximal CRP. Category: Thoracic Purpose: To compare radiologically determined COVID-19 disease severity and pulmonary embolism (PE) rates on initial computed tomography pulmonary angiogram (CTPA), clinical severity and outcomes of patients infected with B1.1.7 lineage compared with those infected with remaining strains. Methods and materials: Single-centre retrospective analysis on a cohort of 139 consecutive patients with polymerase chain reaction (PCR)-confirmed COVID-19 infection who underwent CTPA and viral genome sequencing between 1 December 2020 and 7 January 2021. Two radiologists undertook blinded analysis of the first CTPA since admission and scored out of 25 for lung involvement to produce a CT severity score (CTSS). Pulmonary embolism rates were determined on radiological report. Clinical, biochemical and outcome data was collected with a median follow up of 61 days. Results: 88/139 patients infected with B1.1.7 lineage. A significant difference in venous thromboembolism (VTE) rate was observed between B1.1.7 (1.1%, 1/88) and non-B1.1.7 (13.7%, 7/51) controlling for age, gender, anticoagulation on admission and comorbidities (adjusted p=0.0104). No difference in CTSS or clinical severity (determined by ventilatory requirements or oxygen saturations), hospital length of stay, admission to critical care or death between B1.1.7 and non-B1.1.7. However, significantly higher C-reactive protein (CRP) was found in non-B1.1.7 versus B1.1.7 (mean CRP 179 versus 134, adjusted p<0.0001). Conclusion: Although B1.1.7 variant has been shown to associate with increased mortality and disease severity, we did not demonstrate a difference in CT severity score nor in clinical severity or outcomes. Further, patients with non-B.1.1.7 had a significant higher rate of pulmonary embolism and higher maximal CRP.