Key result
Coronary artery calcium measured by Weston Score and aortic valve calcifications were significantly higher in COVID-19 patients requiring ICU admission and invasive ventilation compared to non-ICU patients.
Why the study?
Cardiovascular diseases worsen outcomes in COVID-19, and high CACS and aortic valve calcifications increase cardiovascular risk, prompting evaluation of their presence and prognostic role on chest CT.
Are higher coronary artery calcium scores and aortic valve calcifications associated with ICU admission and invasive ventilation in hospitalized COVID-19 patients?
Case-Control (n=150)
No
Are higher coronary artery calcium scores and aortic valve calcifications associated with ICU admission and invasive ventilation in hospitalized COVID-19 patients?
Coronary artery and aortic valve calcifications on admission chest CT are significantly higher in COVID-19 patients requiring ICU admission, suggesting a predictive role for cardiovascular imaging findings in disease severity.
Answers are grounded in this paper and cite their sources.
Cardiovascular calcifications on CT may flag higher-risk COVID-19 patients; leaves open predictive value and requires prospective validation.
Objectives: Cardiovascular diseases cause worse outcomes in patients affected by COVID-19. High coronary artery calcium score (CACS) and aortic valve calcifications (AC) increase cardiovascular risk. Our purpose is to evaluate CACS, measured by Weston Score (WS), and presence of AC in chest CT of COVID-19 patients and possibly to investigate their prognostic role. Material and methods: This retrospective case-control study includes 150 hospitalized COVID-19 patients who underwent a chest CT at admission. The case group (Group A) was formed by 50 in-patients in Intensive Care Unit (ICU) under invasive ventilation (IV), while the matching control group for sex, age and BMI (Group B) was formed by 100 in-patients in non-ICU units, not under IV. After, a second case-control selection was originated from these two Groups: the case group (Group A1) composed by 30 patients selected from Group A, and the matching control group for age, sex, BMI and CT lung severity score (LSS) (Group B1) composed by 60 patients selected from Group B. WS and the presence of AC were compared between Groups A and B, and between Groups A1 and B1. Moreover, LSS and WS were correlated. Parametric tests were used for statistical analysis. Material and methods: This retrospective case-control study includes 150 hospitalized COVID-19 patients who underwent a chest CT at admission. The case group (Group A) was formed by 50 in-patients in Intensive Care Unit (ICU) under invasive ventilation (IV), while the matching control group for sex, age and BMI (Group B) was formed by 100 in-patients in non-ICU units, not under IV. After, a second case-control selection was originated from these two Groups: the case group (Group A1) composed by 30 patients selected from Group A, and the matching control group for age, sex, BMI and CT lung severity score (LSS) (Group B1) composed by 60 patients selected from Group B. WS and the presence of AC were compared between Groups A and B, and between Groups A1 and B1. Moreover, LSS and WS were correlated. Parametric tests were used for statistical analysis. Results: Among the 150 patients, 105 (70.0%) were male and 45 (30.0%) female. The age was 70.2 ± 13.3 years. LSS was 7.5 ± 3.9, WS was 6.4 ± 3.0; AC was present in 97/150 (64.7%). WS was significantly higher in Group A than in Group B, respectively, 7.4 ± 4.0 and 5.7 ± 2.6 (p=0.0146), and also the presence of AC, respectively, 41/50 (82.0%) vs 56/100 (56.0%) (p=0.0016). In Group B, LSS and WS had a linear positive correlation (r=0.2240, p=0.0405). Finally, WS and AC were significantly higher in Group A1 compared to Group B1. Conclusions: Both WS and AC were higher in ICU COVID-19 patients than in non-ICU COVID-19 patients: they could have a predictive role in the pejorative evolution of the disease.
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Fogante et al. (2021) conducted a case-control in COVID-19 (n=150). Severe COVID-19 requiring ICU admission and invasive ventilation vs. Non-ICU admission without invasive ventilation was evaluated on Weston Score (WS) for coronary artery calcium (p=0.0146). Coronary artery calcium measured by Weston Score and aortic valve calcifications were significantly higher in COVID-19 patients requiring ICU admission and invasive ventilation compared to non-ICU patients.
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