Association of coronary calcification with prognosis of Covid-19 patients without known heart disease

Risk factors that determine the severity of Covid-19 have not been fully elucidated. The aim of this study was to evaluate the role of coronary artery calcification (CAC) as a risk factor for death or mechanical ventilation (MV) of patients without known heart disease infected with Covid-19. We analyzed 283 consecutive in-patients with acute respiratory symptoms with chest computed tomography (chest-CT), without previous heart disease, and criteria for Covid-19 (RT-PCR positive and/or typical clinical and chest-CT findings). CAC was classified by the number of coronary segments affected as absent (0), mild (1-3), and severe calcification (more than 3). The association between CAC, CAC severity, and death or MV due to severe respiratory failure was assessed by logistic regression. The mean age was 58.7±15.7 years and 54.1% were men. Patients with CAC were older, more likely to have hypertension, and less likely to be obese. CAC was present in 75 patients (26.5%), of which 42 had a mild calcification and 33 had severe calcification, and was associated with death (OR=2.35, 95%CI: 1.01-5.48) or MV (OR=2.72, 95%CI: 1.20-6.20) adjusted for multiple confounders, with significant and increased odds ratio for the severe form of CAC (death: OR=3.70, 95%CI: 1.20-11.42; MV: OR=3.30, 95%CI: 1.09-9.95). We concluded that CAC was an independent risk factor for death or MV in Covid-19 patients without previous heart disease, particularly for those with severe calcification. CAC can be easily visualized on common chest-CT, widely used in evaluation of moderate to severe Covid-19.

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Main Authors: Possari,R.Y., Andrade-Gomes,H.J., Mello,V.C., Galdeano,E.A., Aguiar-Filho,L.F., Bittencourt,M.S., Ponte,E.V., Bertoche,L.R., Caio,L.R.S., Rodrigues,J.D., Alcantara,F.B., Freitas,M.A.C., Sarinho,J.C.G.C., Cervigne,N.K., Rodrigues,W.M., Aprahamian,I.
Format: Digital revista
Language:English
Published: Associação Brasileira de Divulgação Científica 2021
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2021001200612
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spelling oai:scielo:S0100-879X20210012006122021-12-01Association of coronary calcification with prognosis of Covid-19 patients without known heart diseasePossari,R.Y.Andrade-Gomes,H.J.Mello,V.C.Galdeano,E.A.Aguiar-Filho,L.F.Bittencourt,M.S.Ponte,E.V.Bertoche,L.R.Caio,L.R.S.Rodrigues,J.D.Alcantara,F.B.Freitas,M.A.C.Sarinho,J.C.G.C.Cervigne,N.K.Rodrigues,W.M.Aprahamian,I. Covid-19 Coronavirus Coronary artery calcification Mortality Respiratory failure Risk factors that determine the severity of Covid-19 have not been fully elucidated. The aim of this study was to evaluate the role of coronary artery calcification (CAC) as a risk factor for death or mechanical ventilation (MV) of patients without known heart disease infected with Covid-19. We analyzed 283 consecutive in-patients with acute respiratory symptoms with chest computed tomography (chest-CT), without previous heart disease, and criteria for Covid-19 (RT-PCR positive and/or typical clinical and chest-CT findings). CAC was classified by the number of coronary segments affected as absent (0), mild (1-3), and severe calcification (more than 3). The association between CAC, CAC severity, and death or MV due to severe respiratory failure was assessed by logistic regression. The mean age was 58.7±15.7 years and 54.1% were men. Patients with CAC were older, more likely to have hypertension, and less likely to be obese. CAC was present in 75 patients (26.5%), of which 42 had a mild calcification and 33 had severe calcification, and was associated with death (OR=2.35, 95%CI: 1.01-5.48) or MV (OR=2.72, 95%CI: 1.20-6.20) adjusted for multiple confounders, with significant and increased odds ratio for the severe form of CAC (death: OR=3.70, 95%CI: 1.20-11.42; MV: OR=3.30, 95%CI: 1.09-9.95). We concluded that CAC was an independent risk factor for death or MV in Covid-19 patients without previous heart disease, particularly for those with severe calcification. CAC can be easily visualized on common chest-CT, widely used in evaluation of moderate to severe Covid-19.info:eu-repo/semantics/openAccessAssociação Brasileira de Divulgação CientíficaBrazilian Journal of Medical and Biological Research v.54 n.12 20212021-01-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2021001200612en10.1590/1414-431x2021e11681
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language English
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author Possari,R.Y.
Andrade-Gomes,H.J.
Mello,V.C.
Galdeano,E.A.
Aguiar-Filho,L.F.
Bittencourt,M.S.
Ponte,E.V.
Bertoche,L.R.
Caio,L.R.S.
Rodrigues,J.D.
Alcantara,F.B.
Freitas,M.A.C.
Sarinho,J.C.G.C.
Cervigne,N.K.
Rodrigues,W.M.
Aprahamian,I.
spellingShingle Possari,R.Y.
Andrade-Gomes,H.J.
Mello,V.C.
Galdeano,E.A.
Aguiar-Filho,L.F.
Bittencourt,M.S.
Ponte,E.V.
Bertoche,L.R.
Caio,L.R.S.
Rodrigues,J.D.
Alcantara,F.B.
Freitas,M.A.C.
Sarinho,J.C.G.C.
Cervigne,N.K.
Rodrigues,W.M.
Aprahamian,I.
Association of coronary calcification with prognosis of Covid-19 patients without known heart disease
author_facet Possari,R.Y.
Andrade-Gomes,H.J.
Mello,V.C.
Galdeano,E.A.
Aguiar-Filho,L.F.
Bittencourt,M.S.
Ponte,E.V.
Bertoche,L.R.
Caio,L.R.S.
Rodrigues,J.D.
Alcantara,F.B.
Freitas,M.A.C.
Sarinho,J.C.G.C.
Cervigne,N.K.
Rodrigues,W.M.
Aprahamian,I.
author_sort Possari,R.Y.
title Association of coronary calcification with prognosis of Covid-19 patients without known heart disease
title_short Association of coronary calcification with prognosis of Covid-19 patients without known heart disease
title_full Association of coronary calcification with prognosis of Covid-19 patients without known heart disease
title_fullStr Association of coronary calcification with prognosis of Covid-19 patients without known heart disease
title_full_unstemmed Association of coronary calcification with prognosis of Covid-19 patients without known heart disease
title_sort association of coronary calcification with prognosis of covid-19 patients without known heart disease
description Risk factors that determine the severity of Covid-19 have not been fully elucidated. The aim of this study was to evaluate the role of coronary artery calcification (CAC) as a risk factor for death or mechanical ventilation (MV) of patients without known heart disease infected with Covid-19. We analyzed 283 consecutive in-patients with acute respiratory symptoms with chest computed tomography (chest-CT), without previous heart disease, and criteria for Covid-19 (RT-PCR positive and/or typical clinical and chest-CT findings). CAC was classified by the number of coronary segments affected as absent (0), mild (1-3), and severe calcification (more than 3). The association between CAC, CAC severity, and death or MV due to severe respiratory failure was assessed by logistic regression. The mean age was 58.7±15.7 years and 54.1% were men. Patients with CAC were older, more likely to have hypertension, and less likely to be obese. CAC was present in 75 patients (26.5%), of which 42 had a mild calcification and 33 had severe calcification, and was associated with death (OR=2.35, 95%CI: 1.01-5.48) or MV (OR=2.72, 95%CI: 1.20-6.20) adjusted for multiple confounders, with significant and increased odds ratio for the severe form of CAC (death: OR=3.70, 95%CI: 1.20-11.42; MV: OR=3.30, 95%CI: 1.09-9.95). We concluded that CAC was an independent risk factor for death or MV in Covid-19 patients without previous heart disease, particularly for those with severe calcification. CAC can be easily visualized on common chest-CT, widely used in evaluation of moderate to severe Covid-19.
publisher Associação Brasileira de Divulgação Científica
publishDate 2021
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2021001200612
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