In-hospital prognostic role of coronary atherosclerotic burden in COVID-19 patients.
J Cardiovasc Med (Hagerstown)
; 22(11): 818-827, 2021 11 01.
Article
in English
| MEDLINE | ID: covidwho-1450783
ABSTRACT
AIMS:
Currently, there are few available data regarding a possible role for subclinical atherosclerosis as a risk factor for mortality in Coronavirus Disease 19 (COVID-19) patients. We used coronary artery calcium (CAC) score derived from chest computed tomography (CT) scan to assess the in-hospital prognostic role of CAC in patients affected by COVID-19 pneumonia.METHODS:
Electronic medical records of patients with confirmed diagnosis of COVID-19 were retrospectively reviewed. Patients with known coronary artery disease (CAD) were excluded. A CAC score was calculated for each patient and was used to categorize them into one of four groups 0, 1-299, 300-999 and at least 1000. The primary endpoint was in-hospital mortality for any cause.RESULTS:
The final population consisted of 282 patients. Fifty-seven patients (20%) died over a follow-up time of 40 days. The presence of CAC was detected in 144 patients (51%). Higher CAC score values were observed in nonsurvivors [median 87, interquartile range (IQR) 0.0-836] compared with survivors (median 0, IQR 0.0-136). The mortality rate in patients with a CAC score of at least 1000 was significantly higher than in patients without coronary calcifications (50 vs. 11%) and CAC score 1-299 (50 vs. 23%), Pâ<â0.05. After adjusting for clinical variables, the presence of any CAC categories was not an independent predictor of mortality; however, a trend for increased risk of mortality was observed in patients with CAC of at least 1000.CONCLUSION:
The correlation between CAC score and COVID-19 is fascinating and under-explored. However, in multivariable analysis, the CAC score did not show an additional value over more robust clinical variables in predicting in-hospital mortality. Only patients with the highest atherosclerotic burden (CAC ≥1000) could represent a high-risk population, similarly to patients with known CAD.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Coronary Artery Disease
/
Hospital Mortality
/
Coronary Vessels
/
Vascular Calcification
/
COVID-19
Type of study:
Cohort study
/
Diagnostic study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Europa
Language:
English
Journal:
J Cardiovasc Med (Hagerstown)
Journal subject:
Vascular Diseases
/
Cardiology
Year:
2021
Document Type:
Article
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