key: cord-0872950-cbw8vw1a
authors: Mungmunpuntipantip, Rujittika; Wiwanitkit, Viroj
title: Correspondence on “aortic enlargement and COVID-19”
date: 2022-04-13
journal: Vascular
DOI: 10.1177/17085381221087816
sha: 15e14f5305433e268c905f1e40ea8fd67ec2930a
doc_id: 872950
cord_uid: cbw8vw1a

nan

Dear Editor, we would like to share ideas on the publication "An interesting finding: What is the relation between aortic enlargement and COVID-19? 1 " In the present study, medical records and thorax tomographies of patients were analyzed. Bitargil et al. mentioned that "the mean aortic diameter of COVID-19 patients is larger than non-COVID-19 patients with similar comorbidities referred to a pandemic …… COVID-19 was the leading factor. 1 " We agree that COVID-19 might have some clinical effects on vascular system. If COVID-19 results in enlargement of aorta, the pathological process should be acute process that the change can be detected in a short period of infection. The possible pathological process might be an inflammatory process affect heart and large vessel. 2 The present study might show that there is a significant increased diameter of aorta in COVID-19 case. The diameter enlargement might or might not be associated with COVID-19. The important concern is on the pre-COVID-19 vascular status of the patients. In this study, there is no data on pre-COVID-19 vascular/health status of the patients. As Bitargil et al. noted, there are several possible confounding factors that might affect the aorta. Some patients might already have the vascular problem prior to COVID-19. In addition to the underlying personal illness, there is possibility of other concurrent medical problem in COVID-19 patient that might also cause enlargement of aorta. For example, dengue is a possible concurrent medical problem 3 and dengue can cause enlargement of aorta. 4 Regarding the investigation technique, thorax tomography, the diameter of the aorta grows with age and male gender. 5 To distinguish pathologic atherosclerotic alterations in the ascending aorta, gender-specific and ageadjusted aortic diameter are required. 5 Finally, it should be noted that the interpersonal variability in interpretation of aorta diameter from tomography image is high 5 and if there are many tomography radiologists in the present report by Bitargil et al., it is necessary to assess interpersonal variability. These points should be discussed and if further studies are conducted, it is necessary to recognize these basic considerations.

The author(s) disclosed the following conflicting interest for the research, authorship, and/or publication of this article: authors cannot pay for any charge and ask for full waiving for this correspondence.

The author(s) received no financial support for the research, authorship, and/or publication of this article.

An interesting finding: what is the relation between aortic enlargement and COVID-19?

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RM 50 % and VW 50 %: (1a) Substantial contributions to study conception and design, (1b) Substantial contributions to acquisition of data, (1c) Substantial contributions to analysis and interpretation of data, (2) Drafting the article or revising it critically for important intellectual content, and (3) Final approval of the version of the article to be published.

Rujittika Mungmunpuntipantip  https://orcid.org/0000-0003-0078-7897