Coronary and total thoracic calcium scores predict mortality and provides pathophysiologic insights in COVID-19 patients.

Giannini, Francesco; Toselli, Marco; Palmisano, Anna; Cereda, Alberto; Vignale, Davide; Leone, Riccardo; Nicoletti, Valeria; Gnasso, Chiara; Monello, Alberto; Manfrini, Marco; Khokhar, Arif; Sticchi, Alessandro; Biagi, Andrea; Turchio, Piergiorgio; Tacchetti, Carlo; Landoni, Giovanni; Boccia, Edda; Campo, Gianluca; Scoccia, Alessandra; Ponticelli, Francesco; Danzi, Gian Battista; Loffi, Marco; Muri, Margherita; Pontone, Gianluca; Andreini, Daniele; Mancini, Elisabetta Maria; Casella, Gianni; Iannopollo, Gianmarco; Nannini, Tommaso; Ippolito, Davide; Bellani, Giacomo; Franzesi, Camillo Talei; Patelli, Gianluigi; Besana, Francesca; Costa, Claudia; Vignali, Luigi; Benatti, Giorgio; Sverzellati, Nicola; Scarnecchia, Elisa; Lombardo, Francesco Paolo; Anastasio, Fabio; Iannaccone, Mario; Vaudano, Paolo Giacomo; Pacielli, Alberto; Baffoni, Lucio; Gardi, Iljia; Cesini, Elisabetta; Sperandio, Massimiliano; Micossi, Chiara; De Carlini, Caterina Chiara

Giannini, Francesco; Toselli, Marco; Palmisano, Anna; Cereda, Alberto; Vignale, Davide; Leone, Riccardo; Nicoletti, Valeria; Gnasso, Chiara; Monello, Alberto; Manfrini, Marco; Khokhar, Arif; Sticchi, Alessandro; Biagi, Andrea; Turchio, Piergiorgio; Tacchetti, Carlo; Landoni, Giovanni; Boccia, Edda; Campo, Gianluca; Scoccia, Alessandra; Ponticelli, Francesco; Danzi, Gian Battista; Loffi, Marco; Muri, Margherita; Pontone, Gianluca; Andreini, Daniele; Mancini, Elisabetta Maria; Casella, Gianni; Iannopollo, Gianmarco; Nannini, Tommaso; Ippolito, Davide; Bellani, Giacomo; Franzesi, Camillo Talei; Patelli, Gianluigi; Besana, Francesca; Costa, Claudia; Vignali, Luigi; Benatti, Giorgio; Sverzellati, Nicola; Scarnecchia, Elisa; Lombardo, Francesco Paolo; Anastasio, Fabio; Iannaccone, Mario; Vaudano, Paolo Giacomo; Pacielli, Alberto; Baffoni, Lucio; Gardi, Iljia; Cesini, Elisabetta; Sperandio, Massimiliano; Micossi, Chiara; De Carlini, Caterina Chiara.

Giannini F; GVM Care & Research Maria Cecilia Hospital, Cotignola, Italy. Electronic address: giannini_fra@yahoo.it.
Toselli M; GVM Care & Research Maria Cecilia Hospital, Cotignola, Italy.
Palmisano A; IRCCS San Raffaele Scientific Institute, Italy; Vita-Salute San Raffaele University, Italy.
Cereda A; GVM Care & Research Maria Cecilia Hospital, Cotignola, Italy.
Vignale D; IRCCS San Raffaele Scientific Institute, Italy; Vita-Salute San Raffaele University, Italy.
Leone R; IRCCS San Raffaele Scientific Institute, Italy; Vita-Salute San Raffaele University, Italy.
Nicoletti V; IRCCS San Raffaele Scientific Institute, Italy; Vita-Salute San Raffaele University, Italy.
Gnasso C; IRCCS San Raffaele Scientific Institute, Italy; Vita-Salute San Raffaele University, Italy.
Monello A; Guglielmo da Saliceto Hospital, Piacenza, Italy.
Manfrini M; GVM Care & Research Maria Cecilia Hospital, Cotignola, Italy.
Khokhar A; GVM Care & Research Maria Cecilia Hospital, Cotignola, Italy.
Sticchi A; GVM Care & Research Maria Cecilia Hospital, Cotignola, Italy.
Biagi A; Guglielmo da Saliceto Hospital, Piacenza, Italy.
Turchio P; Guglielmo da Saliceto Hospital, Piacenza, Italy.
Tacchetti C; IRCCS San Raffaele Scientific Institute, Italy; Vita-Salute San Raffaele University, Italy.
Landoni G; IRCCS San Raffaele Scientific Institute, Italy; Vita-Salute San Raffaele University, Italy.
Boccia E; IRCCS San Raffaele Scientific Institute, Italy.
Campo G; Azienda Ospedaliero-Universitaria di Ferrara, Cona, FE, Italy.
Scoccia A; Azienda Ospedaliero-Universitaria di Ferrara, Cona, FE, Italy.
Ponticelli F; GVM Care & Research Maria Cecilia Hospital, Cotignola, Italy.
Danzi GB; Ospedale di Cremona, Cremona, Italy.
Loffi M; Ospedale di Cremona, Cremona, Italy.
Muri M; Ospedale di Cremona, Cremona, Italy.
Pontone G; Centro Cardiologico Monzino IRCCS, Milano, Italy.
Andreini D; Centro Cardiologico Monzino IRCCS, Milano, Italy.
Mancini EM; Centro Cardiologico Monzino IRCCS, Milano, Italy.
Casella G; Ospedale Maggiore, Bologna, Italy.
Iannopollo G; Ospedale Maggiore, Bologna, Italy.
Nannini T; Ospedale Maggiore, Bologna, Italy.
Ippolito D; San Gerardo Hospital, Monza, Italy.
Bellani G; San Gerardo Hospital, Monza, Italy.
Franzesi CT; San Gerardo Hospital, Monza, Italy.
Patelli G; ASST Bolognini Hospital, Bergamo Est, Italy.
Besana F; ASST Bolognini Hospital, Bergamo Est, Italy.
Costa C; ASST Bolognini Hospital, Bergamo Est, Italy.
Vignali L; Parma University Hospital, Parma, Italy.
Benatti G; Parma University Hospital, Parma, Italy.
Sverzellati N; Parma University Hospital, Parma, Italy.
Scarnecchia E; ASST Valtellina and Alto Lario, "Eugenio Morelli Hospital", Sondalo, Italy.
Lombardo FP; ASST Valtellina and Alto Lario, "Eugenio Morelli Hospital", Sondalo, Italy.
Anastasio F; ASST Valtellina and Alto Lario, "Eugenio Morelli Hospital", Sondalo, Italy.
Iannaccone M; San Giovanni Bosco Hospital, ASL Città di Torino, Turin, Italy.
Vaudano PG; San Giovanni Bosco Hospital, ASL Città di Torino, Turin, Italy.
Pacielli A; San Giovanni Bosco Hospital, ASL Città di Torino, Turin, Italy.
Baffoni L; GVM Care & Research Maria Cecilia Hospital, Cotignola, Italy; Casa di Cura Villa dei Pini, Civitanova Marche, Italy.
Gardi I; GVM Care & Research Maria Cecilia Hospital, Cotignola, Italy.
Cesini E; Casa di Cura Villa dei Pini, Civitanova Marche, Italy.
Sperandio M; ICC Istituto Clinico Casalpalocco, Rome, Italy.
Micossi C; ICC Istituto Clinico Casalpalocco, Rome, Italy.
De Carlini CC; San L. Mandic Hospital, Merate, Italy.

J Cardiovasc Comput Tomogr ; 15(5): 421-430, 2021.

Article in English | MEDLINE | ID: covidwho-1141959

ABSTRACT

ABSTRACT

BACKGROUND:

Coronavirus disease 2019 (COVID-19) has spread worldwide determining dramatic impacts on healthcare systems. Early identification of high-risk parameters is required in order to provide the best therapeutic approach. Coronary, thoracic aorta and aortic valve calcium can be measured from a non-gated chest computer tomography (CT) and are validated predictors of cardiovascular events and all-cause mortality. However, their prognostic role in acute systemic inflammatory diseases, such as COVID-19, has not been investigated.

OBJECTIVES:

The aim was to evaluate the association of coronary artery calcium and total thoracic calcium on in-hospital mortality in COVID-19 patients.

METHODS:

1093 consecutive patients from 16 Italian hospitals with a positive swab for COVID-19 and an admission chest CT for pneumonia severity assessment were included. At CT, coronary, aortic valve and thoracic aorta calcium were qualitatively and quantitatively evaluated separately and combined together (total thoracic calcium) by a central Core-lab blinded to patients' outcomes.

RESULTS:

Non-survivors compared to survivors had higher coronary artery [Agatston (467.76 â± â570.92 vs 206.80 â± â424.13 âmm2, p â< â0.001); Volume (487.79 â± â565.34 vs 207.77 â± â406.81, p â< â0.001)], aortic valve [Volume (322.45 â± â390.90 vs 98.27 â± â250.74 mm2, p â< â0.001; Agatston 337.38 â± â414.97 vs 111.70 â± â282.15, p â< â0.001)] and thoracic aorta [Volume (3786.71 â± â4225.57 vs 1487.63 â± â2973.19 mm2, p â< â0.001); Agatston (4688.82 â± â5363.72 vs 1834.90 â± â3761.25, p â< â0.001)] calcium values. Coronary artery calcium (HR 1.308; 95% CI, 1.046-1.637, p â= â0.019) and total thoracic calcium (HR 1.975; 95% CI, 1.200-3.251, p â= â0.007) resulted to be independent predictors of in-hospital mortality.

CONCLUSION:

Coronary, aortic valve and thoracic aortic calcium assessment on admission non-gated CT permits to stratify the COVID-19 patients in-hospital mortality risk.

Subject(s)

COVID-19/mortality; COVID-19/physiopathology; Computed Tomography Angiography; Vascular Calcification/mortality; Vascular Calcification/physiopathology; Aged; Aged, 80 and over; Aorta, Thoracic/diagnostic imaging; Aortic Diseases/diagnostic imaging; Aortic Diseases/mortality; Aortic Diseases/physiopathology; Aortic Valve/diagnostic imaging; COVID-19/diagnostic imaging; Coronary Vessels/diagnostic imaging; Female; Humans; Italy/epidemiology; Male; Middle Aged; Pneumonia, Viral/diagnostic imaging; Pneumonia, Viral/mortality; Pneumonia, Viral/physiopathology; Pneumonia, Viral/virology; Predictive Value of Tests; Retrospective Studies; SARS-CoV-2; Severity of Illness Index; Vascular Calcification/diagnostic imaging

Keywords

Aortic valve; COVID-19; Calcification; Calcium score; Coronary artery; In-hospital mortality; Thoracic aorta

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Vascular Calcification / Computed Tomography Angiography / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study / Qualitative research Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: J Cardiovasc Comput Tomogr Journal subject: Vascular Diseases / Cardiology / Radiology Year: 2021 Document Type: Article

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