The Relationship of Aortic Knob Width and Prognosis in COVID-19 Patients

Introduction: To investigate the relationship between aortic knob width (AKW) and prognosis in patients hospitalized due to coronavirus disease-2019 (COVID-19), and to determine whether AKW can be used as a predictor of in-hospital mortality. Methods: This cross-sectional study included 222 patients who were hospitalized with COVID-19 following emergency department admission. Based on the clinical outcome, patients were categorized into two groups: those who died during hospitalization (group 1, n=64) and those who survived (group 2, n=158). Demographic, clinical, laboratory, and radiological data were collected retrospectively. AKW was measured on chest radiographs, and its association with in-hospital mortality was assessed through multivariate logistic regression and receiver operating characteristic curve analysis. Results: AKW was significantly higher in deceased patients compared to survivors (45.1±8.8 mm vs. 36.7±6.7 mm; p<0.001). A cut-off value of 40 mm for AKW predicted in-hospital mortality with 76.6% sensitivity and 70.3% specificity. AKW was found to be an independent predictor of in-hospital mortality (odds ratio: 1.196, 95% confidence interval: 1.106-1.293, p<0.001). AKW showed significant correlations with age, inflammatory markers (C-reactive protein, ferritin, procalcitonin), and clinical severity parameters, such as oxygen saturation and respiratory rate. Conclusion: AKW measured on chest X-rays at the time of admission is a non-invasive and accessible prognostic marker in hospitalized COVID-19 patients. Values above 40 mm may indicate increased mortality risk, and these patients should be monitored more closely during hospitalization.