Purpose Cardiovascular comorbidity anticipates severe progression of COVID-19 and becomes evident by coronary artery calcification (CAC) on low-dose chest computed tomography (LDCT). The purpose of this study was to predict a patient’s obligation of intensive care treatment by evaluating the coronary calcium burden on the initial diagnostic LDCT. Methods Eighty-nine consecutive patients with parallel LDCT and positive RT-PCR for SARS-CoV-2 were included from three centers. The primary endpoint was admission to ICU, tracheal intubation, or death in the 22-day follow-up period. CAC burden was represented by the Agatston score. Multivariate logistic regression was modeled for prediction of the primary endpoint by the independent variables “Agatston score > 0”, as well as the CT lung involvement score, patient sex, age, clinical predictors of severe COVID-19 progression (history of hypertension, diabetes, prior cardiovascular event, active smoking, or hyperlipidemia), and laboratory parameters (creatinine, C-reactive protein, leucocyte, as well as thrombocyte counts, relative lymphocyte count, d-dimer, and lactate dehydrogenase levels). Results After excluding multicollinearity, “Agatston score >0” was an independent regressor within multivariate analysis for prediction of the primary endpoint (p<0.01). Further independent regressors were creatinine (p = 0.02) and leucocyte count (p = 0.04). The Agatston score was significantly higher for COVID-19 cases which completed the primary endpoint (64.2 [interquartile range 1.7–409.4] vs. 0 [interquartile range 0–0]). Conclusion CAC scoring on LDCT might help to predict future obligation of intensive care treatment at the day of patient admission to the hospital.
【초록키워드】 COVID-19, SARS-CoV-2, severe COVID-19, lung involvement, hospital, diagnostic, Comorbidity, intubation, Sex, C-reactive protein, D-dimer, progression, diabetes, smoking, hypertension, lactate dehydrogenase, ICU, cardiovascular, Computed tomography, Chest computed tomography, Lymphocyte count, lymphocyte, low-dose, Patient, death, Laboratory parameters, Logistic regression, age, predictor, Admission, predict, calcium, Multivariate analysis, positive RT-PCR, Lactate, creatinine, primary endpoint, Analysis, COVID-19 cases, leucocyte, thrombocyte, Coronary artery, independent variables, interquartile range, independent variable, follow-up period, COVID-19 case, intensive care treatment, multivariate logistic regression, help, multivariate, tracheal intubation, hyperlipidemia, three centers, active smoking, multicollinearity, laboratory parameter, independent, initial, Result, significantly higher, tracheal, consecutive patient, the primary endpoint, 【제목키워드】 progression, Chest CT,