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Background: Enlargement of pulmonary artery (PA) trunk diameter could be helpful in risk stratification by the chest CT on the admission of COVID-19 patients.Methods: The aim was to investigate the association between pulmonary artery enlargement and overall mortality in COVID-19 pneumonia. We conducted a single-center, retrospective, observational study between January 2021 and May 2021 in tertiary level hospitals in Gebze, Turkey. According to their survivor status, subjects were divided into two groups (survivors and non-survivors). Then biochemical, demographic, and clinical parameters were compared via the two groups to assess the predictive value of PA diameter on chest CT images.Results: In the enrolled 594 COVID-19 in-hospital patients (median age was 45 (34-58) years, and 263 patients (44.3%) were female), 44 patients (7.4%) died during their hospitalization. The time-dependent multivariate Cox-proportion regression model yielded main PA ≥ 29 mm on admission showed that as independent predictors of subsequent death (long rank <0.001, median survival time 28 days). Cumulative survival rates were MPAD ≥ 29 mm 45% and < 29 mm 90% respectively (p < 0.001).Conclusions: PA dilatation is strongly associated with in-hospital mortality in hospitalized patients with COVID-19 pneumonia. Thus increased PA diameter on chest CT at admission may guide rapid and early diagnosis of high-risk patients.

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