Coronary and total thoracic calcium scores predict mortality and provides pathophysiologic insights in COVID-19 patients.
J Cardiovasc Comput Tomogr
; 15(5): 421-430, 2021.
Artículo
en Inglés
| MEDLINE | ID: covidwho-1141959
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.Palabras clave
Texto completo:
Disponible
Colección:
Bases de datos internacionales
Base de datos:
MEDLINE
Asunto principal:
Calcificación Vascular
/
Angiografía por Tomografía Computarizada
/
COVID-19
Tipo de estudio:
Estudios diagnósticos
/
Estudio experimental
/
Estudio observacional
/
Estudio pronóstico
/
Investigación cualitativa
Límite:
Anciano
/
Femenino
/
Humanos
/
Masculino
/
Middle aged
País/Región como asunto:
Europa
Idioma:
Inglés
Revista:
J Cardiovasc Comput Tomogr
Asunto de la revista:
Angiología
/
Cardiología
/
Radiología
Año:
2021
Tipo del documento:
Artículo
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