Coronary and total thoracic calcium scores predict mortality and provides pathophysiologic insights in COVID-19 patients

被引：26

作者：

Giannini, Francesco ^{[1
]}

Toselli, Marco ^{[1
]}

Palmisano, Anna ^{[2
,3
]}

Cereda, Alberto ^{[1
]}

Vignale, Davide ^{[2
,3
]}

Leone, Riccardo ^{[2
,3
]}

Nicoletti, Valeria ^{[2
,3
]}

Gnasso, Chiara ^{[2
,3
]}

Monello, Alberto ^{[4
]}

Manfrini, Marco ^{[1
]}

Khokhar, Arif ^{[1
]}

Sticchi, Alessandro ^{[1
]}

Biagi, Andrea ^{[4
]}

Turchio, Piergiorgio ^{[4
]}

Tacchetti, Carlo ^{[2
,3
]}

Landoni, Giovanni ^{[2
,3
]}

Boccia, Edda ^{[2
]}

Campo, Gianluca ^{[5
]}

Scoccia, Alessandra ^{[5
]}

Ponticelli, Francesco ^{[1
]}

Danzi, Gian Battista ^{[6
]}

Loffi, Marco ^{[6
]}

Muri, Margherita ^{[6
]}

Pontone, Gianluca ^{[7
]}

Andreini, Daniele ^{[7
]}

Mancini, Elisabetta Maria ^{[7
]}

Casella, Gianni ^{[8
]}

Iannopollo, Gianmarco ^{[8
]}

Nannini, Tommaso ^{[8
]}

Ippolito, Davide ^{[9
]}

Bellani, Giacomo ^{[9
]}

Franzesi, Camillo Talei ^{[9
]}

Patelli, Gianluigi ^{[10
]}

Besana, Francesca ^{[10
]}

Costa, Claudia ^{[10
]}

Vignali, Luigi ^{[11
]}

Benatti, Giorgio ^{[11
]}

Sverzellati, Nicola ^{[11
]}

Scarnecchia, Elisa ^{[12
]}

Lombardo, Francesco Paolo ^{[12
]}

Anastasio, Fabio ^{[12
]}

Iannaccone, Mario ^{[13
]}

Vaudano, Paolo Giacomo ^{[13
]}

Pacielli, Alberto ^{[13
]}

Baffoni, Lucio ^{[1
,14
]}

Gardi, Iljia ^{[1
]}

Cesini, Elisabetta ^{[14
]}

Sperandio, Massimiliano ^{[15
]}

Micossi, Chiara ^{[15
]}

De Carlini, Caterina Chiara ^{[16
]}

机构：

[1] GVM Care & Res Maria Cecilia Hosp, Cotignola, Italy

[2] IRCCS San Raffaele Sci Inst, Milan, MI, Italy

[3] Univ Vita Salute San Raffaele, Milan, MI, Italy

[4] Guglielmo da Saliceto Hosp, Piacenza, Italy

[5] Azienda Osped Univ Ferrara, Cona, FE, Italy

[6] Osped Cremona, Cremona, Italy

[7] Ctr Cardiol Monzino IRCCS, Milan, Italy

[8] Osped Maggiore Bologna, Bologna, Italy

[9] San Gerardo Hosp, Monza, Italy

[10] ASST Bolognini Hosp, Bergamo Est, Italy

[11] Parma Univ Hosp, Parma, Italy

[12] Eugenio Morelli Hosp, ASST Valtellina & Alto Lario, Sondalo, Italy

[13] ASL Citta Torino, San Giovanni Bosco Hosp, Turin, Italy

[14] Casa Cura Villa Pini, Civitanova Marche, Italy

[15] ICC Ist Clin Casalpalocco, Rome, Italy

[16] San L Mandic Hosp, Merate, Italy

[17] ASST Papa Giovanni XXIII, Bergamo, Italy

来源：

JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY | 2021年 / 15卷 / 05期

关键词：

COVID-19; Coronary artery; Aortic valve; Thoracic aorta; Calcification; Calcium score; In-hospital mortality; DISEASE; 2019; COVID-19; ALL-CAUSE MORTALITY; ARTERY CALCIUM; COMPUTED-TOMOGRAPHY; QUANTIFICATION; ASSOCIATION; POPULATION; EVENTS; RISK;

D O I：

10.1016/j.jcct.2021.03.003

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Coronavirus disease 2019 (COVID-19) has spread worldwide determining dramatic impacts on healthcare systems. Early identification of high-risk parameters is required in order to provide the best therapeutic approach. Coronary, thoracic aorta and aortic valve calcium can be measured from a non-gated chest computer tomography (CT) and are validated predictors of cardiovascular events and all-cause mortality. However, their prognostic role in acute systemic inflammatory diseases, such as COVID-19, has not been investigated. Objectives: The aim was to evaluate the association of coronary artery calcium and total thoracic calcium on in-hospital mortality in COVID-19 patients. Methods: 1093 consecutive patients from 16 Italian hospitals with a positive swab for COVID-19 and an admission chest CT for pneumonia severity assessment were included. At CT, coronary, aortic valve and thoracic aorta calcium were qualitatively and quantitatively evaluated separately and combined together (total thoracic calcium) by a central Core-lab blinded to patients' outcomes. Results: Non-survivors compared to survivors had higher coronary artery [Agatston (467.76 +/- 570.92 vs 206.80 +/- 424.13 mm(2), p < 0.001); Volume (487.79 +/- 565.34 vs 207.77 +/- 406.81, p < 0.001)], aortic valve [Volume (322.45 +/- 390.90 vs 98.27 +/- 250.74 mm(2), p < 0.001; Agatston 337.38 +/- 414.97 vs 111.70 +/- 282.15, p < 0.001)] and thoracic aorta [Volume (3786.71 +/- 4225.57 vs 1487.63 +/- 2973.19 mm(2), p < 0.001); Agatston (4688.82 +/- 5363.72 vs 1834.90 +/- 3761.25, p < 0.001)] calcium values. Coronary artery calcium (HR 1.308; 95% CI, 1.046-1.637, p = 0.019) and total thoracic calcium (HR 1.975; 95% CI, 1.200-3.251, p = 0.007) resulted to be independent predictors of in-hospital mortality. Conclusion Coronary, aortic valve and thoracic aortic calcium assessment on admission non-gated CT permits to stratify the COVID-19 patients in-hospital mortality risk.

引用

页码：421 / 430

页数：10

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