Abstract
Background: Recent studies have demonstrated a complex interplay between comorbid cardiovascular disease, COVID-19 pathophysiology, and poor clinical outcomes. Coronary artery calcification (CAC) may therefore aid in risk stratification of COVID-19 patients.
Methods: Non-contrast chest CT studies on 180 COVID-19 patients ≥ age 21 admitted from March 1, 2020 to April 27, 2020 were retrospectively reviewed by two radiologists to determine CAC scores. Following feature selection, multivariable logistic regression was utilized to evaluate the relationship between CAC scores and patient outcomes.
Results: The presence of any identified CAC was associated with intubation (AOR: 3.6, CI: 1.4-9.6) and mortality (AOR: 3.2, CI: 1.4-7.9). Severe CAC was independently associated with intubation (AOR: 4.0, CI: 1.3-13) and mortality (AOR: 5.1, CI: 1.9-15). A greater CAC score (UOR: 1.2, CI: 1.02-1.3) and number of vessels with calcium (UOR: 1.3, CI: 1.02-1.6) was associated with mortality. Visualized coronary stent or coronary artery bypass graft surgery (CABG) had no statistically significant association with intubation (AOR: 1.9, CI: 0.4-7.7) or death (AOR: 3.4, CI: 1.0-12).
Conclusion: COVID-19 patients with any CAC were more likely to require intubation and die than those without CAC. Increasing CAC and number of affected arteries was associated with mortality. Severe CAC was associated with higher intubation risk. Prior CABG or stenting had no association with elevated intubation or death.
Keywords: COVID-19; Computed tomography (CT); Coronary artery calcification (CAC); Coronary artery disease (CAD).
【저자키워드】 COVID-19, computed tomography (CT), Coronary artery calcification (CAC), Coronary artery disease (CAD)., 【초록키워드】 Mortality, intubation, risk, cardiovascular disease, tomography, clinical outcomes, Coronary artery disease, outcomes, risk stratification, Computed tomography, Chest CT, pathophysiology, Patient, death, age, disease, calcium, COVID-19 patients, association, Feature selection, CAD, COVID-19 patient, Artery, Coronary artery, Bypass Graft, coronary artery bypass, multivariable logistic regression, complex interplay, vessels, radiologist, recent, vessel, greater, affected, evaluate, elevated, determine, demonstrated, had no, statistically significant, Increasing, 【제목키워드】 Biomarker, Clinical outcome,