Epicardial adipose tissue volume over 137.1 cm2 on admission chest CT scan independently predicted myocardial injury in patients with COVID-19 (OR 3.058).
Cohort (n=400)
Yes
Does augmented epicardial adipose tissue volume on admission chest CT predict myocardial injury in patients with COVID-19?
Augmented epicardial adipose tissue volume on admission chest CT, along with pre-existing health conditions, is an independent predictor of myocardial injury and adverse outcomes in COVID-19 patients.
Effect estimate: OR 3.058 (95% CI 1.032-9.063)
Absolute Event Rate: 16.2% vs 4.4%
p-value: p=0.044
Background: Myocardial injury is a life-threatening complication of coronavirus disease 2019 (COVID-19). Pre-existing health conditions and early morphological alterations may precipitate cardiac injury and dysfunction after contracting the virus. The current study aimed at assessing potential risk factors for COVID-19 cardiac complications in patients with pre-existing conditions and imaging predictors. Methods and Results: The multi-center, retrospective cohort study consecutively enrolled 400 patients with lab-confirmed COVID-19 in six Chinese hospitals remote to the Wuhan epicenter. Patients were diagnosed with or without the complication of myocardial injury by history and cardiac biomarker Troponin I/T (TnI/T) elevation above the 99th percentile upper reference limit. The majority of COVID-19 patients with myocardial injury exhibited pre-existing health conditions, such as hypertension, diabetes, hypercholesterolemia, and coronary disease. They had increased levels of the inflammatory cytokine interleukin-6 and more in-hospital adverse events (admission to an intensive care unit, invasive mechanical ventilation, or death). Chest CT scan on admission demonstrated that COVID-19 patients with myocardial injury had higher epicardial adipose tissue volume (EATV 139.1 (83.8–195.9) vs. 92.6 (76.2–134.4) cm 2 ; P = 0.036). The optimal EATV cut-off value (137.1 cm 2 ) served as a useful factor for assessing myocardial injury, which yielded sensitivity and specificity of 55.0% (95%CI, 32.0–76.2%) and 77.4% (95%CI, 71.6–82.3%) in adverse cardiac events, respectively. Multivariate logistic regression analysis showed that EATV over 137.1 cm 2 was a strong independent predictor for myocardial injury in patients with COVID-19 OR 3.058, (95%CI, 1.032–9.063); P = 0.044. Conclusions: Augmented EATV on admission chest CT scan, together with the pre-existing health conditions (hypertension, diabetes, and hyperlipidemia) and inflammatory cytokine production, is associated with increased myocardial injury and mortality in COVID-19 patients. Assessment of pre-existing conditions and chest CT scan EATV on admission may provide a threshold point potentially useful for predicting cardiovascular complications of COVID-19.
Wei et al. (Mon,) conducted a cohort in COVID-19 (n=400). Epicardial adipose tissue volume (EATV) > 137.1 cm2 vs. EATV ≤ 137.1 cm2 was evaluated on Myocardial injury (OR 3.058, 95% CI 1.032-9.063, p=0.044). Epicardial adipose tissue volume over 137.1 cm2 on admission chest CT scan independently predicted myocardial injury in patients with COVID-19 (OR 3.058).