Objectives: Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, remains a global health concern. The computed tomography (CT) severity score is widely used as an objective measure of pulmonary involvement, while increased pulmonary artery (PA) diameter has emerged as a potential marker of disease severity. This study aimed to investigate the relationship between CT severity scores, PA diameter, and the D-dimer/CRP ratio, and to determine whether these parameters are independently associated with radiological severity. Materials and methods: This retrospective case-control study included 199 PCR-confirmed COVID-19 patients who underwent chest CT and laboratory evaluation. Sociodemographic and clinical data were obtained from hospital records. Laboratory parameters, including procalcitonin, C-reactive protein (CRP), D-dimer, and the D-dimer/CRP ratio, along with CT findings such as PA diameter, were analyzed. Patients were categorized according to CT severity score (0–25). Multivariable linear regression analysis was performed to identify independent predictors of CT severity. Results: Higher CT severity scores were significantly associated with increased levels of inflammatory and laboratory markers, including procalcitonin, CRP, D-dimer, and troponin (all p < 0.05). Procalcitonin showed a significant positive association with CT severity score. Significant differences between severity groups were also observed for age, hypertension, creatinine, hemoglobin, platelet count, D-dimer/CRP ratio, and PA diameter (all p < 0.05). A modest but significant positive correlation was found between PA diameter and CT severity score ( r = 0.333, p < 0.001). In multivariable analysis, PA diameter (β = 0.194, p = 0.005), D-dimer/CRP ratio (β = −0.177, p = 0.007), age (β = 0.175, p = 0.043), and troponin (β = −0.280, p < 0.001) remained independently associated with CT severity score (R ² = 0.291). Conclusion: Higher CT severity scores are associated with increased PA diameter and lower D-dimer/CRP ratios. Integrating radiological parameters with inflammatory markers may improve early risk stratification in COVID-19 patients.

Metabolic remodeling is increasingly recognized as a key component of cardiomyopathy, yet the circulating organic acid profile associated with this condition remains incompletely characterized. In this case–control study, we investigated differences in circulating organic acid profiles between patients with cardiomyopathy and control participants using targeted liquid chromatography–tandem mass spectrometry (LC-MS/MS). A total of 160 participants were enrolled, including 80 patients with cardiomyopathy and 80 age- and sex-comparable control participants. Circulating organic acids were quantitatively analyzed, and between-group differences were assessed using the two-sided Mann–Whitney U test with Benjamini–Hochberg false discovery rate correction; effect sizes were estimated using Cliff’s delta. Detection rates were also examined because several metabolites included values below the assay limit of detection. Sixteen metabolites remained significant after correction. Among these, 3-hydroxyisovaleric acid demonstrated the largest increase, followed by 2-oxoglutaric acid and 2-methylcitric acid. Additional elevations were observed in citric acid, malic acid, N-acetylaspartic acid, fumaric acid, and suberic acid, whereas 2-oxoadipic acid was reduced. These alterations are consistent with perturbations in mitochondrial intermediary metabolism, branched-chain amino acid catabolism, ketone body metabolism, and tricarboxylic acid cycle-related pathways. However, because comorbidities, renal function, glycemic status, and medication use differed between groups, the findings should be interpreted as phenotype-associated metabolic signals rather than cardiomyopathy-specific causal effects or validated diagnostic biomarkers. In conclusion, targeted LC-MS/MS-based organic acid profiling reveals an altered circulating metabolic pattern in cardiomyopathy, although further prospective studies with individual-level adjustment and external validation are required to determine its clinical relevance.