In-hospital prognostic role of coronary atherosclerotic burden in COVID-19 patients.
COVID-19
/ diagnosis
Coronary Artery Disease
/ diagnosis
Coronary Vessels
/ diagnostic imaging
Female
Heart Disease Risk Factors
Hospital Mortality
Hospitalization
/ statistics & numerical data
Humans
Italy
/ epidemiology
Male
Middle Aged
Predictive Value of Tests
Prognosis
Retrospective Studies
SARS-CoV-2
/ isolation & purification
Tomography, X-Ray Computed
/ methods
Vascular Calcification
/ diagnostic imaging
Journal
Journal of cardiovascular medicine (Hagerstown, Md.)
ISSN: 1558-2035
Titre abrégé: J Cardiovasc Med (Hagerstown)
Pays: United States
ID NLM: 101259752
Informations de publication
Date de publication:
01 11 2021
01 11 2021
Historique:
pubmed:
15
7
2021
medline:
12
10
2021
entrez:
14
7
2021
Statut:
ppublish
Résumé
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. 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. 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%), P < 0.05. 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. 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.
Identifiants
pubmed: 34261078
doi: 10.2459/JCM.0000000000001228
pii: 01244665-202111000-00004
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
818-827Informations de copyright
Copyright © 2021 Italian Federation of Cardiology - I.F.C. All rights reserved.
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