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 ​mm2, 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 mm2, 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 mm2, 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.

Giannini, F., Toselli, M., Palmisano, A., Cereda, A., Vignale, D., Leone, R., et al. (2021). Coronary and total thoracic calcium scores predict mortality and provides pathophysiologic insights in COVID-19 patients. JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY, 15(5 (September–October 2021)), 421-430 [10.1016/j.jcct.2021.03.003].

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

Cereda, Alberto;Ippolito, Davide;Bellani, Giacomo;De Carlini, Caterina Chiara;Spreafico, Cristiano;Maggiolini, Stefano;Bonaffini, Pietro Andrea;Iacovoni, Attilio;Sironi, Sandro;Senni, Michele;
2021

Abstract

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 ​mm2, 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 mm2, 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 mm2, 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.
Articolo in rivista - Articolo scientifico
Aortic valve; Calcification; Calcium score; Coronary artery; COVID-19; In-hospital mortality; Thoracic aorta;
English
421
430
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Giannini, F., Toselli, M., Palmisano, A., Cereda, A., Vignale, D., Leone, R., et al. (2021). Coronary and total thoracic calcium scores predict mortality and provides pathophysiologic insights in COVID-19 patients. JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY, 15(5 (September–October 2021)), 421-430 [10.1016/j.jcct.2021.03.003].
Giannini, F; Toselli, M; Palmisano, A; Cereda, A; Vignale, D; Leone, R; Nicoletti, V; Gnasso, C; Monello, A; Manfrini, M; Khokhar, A; Sticchi, A; Biagi, A; Turchio, P; Tacchetti, C; Landoni, G; Boccia, E; Campo, G; Scoccia, A; Ponticelli, F; Danzi, G; Loffi, M; Muri, M; Pontone, G; Andreini, D; Mancini, E; Casella, G; Iannopollo, G; Nannini, T; Ippolito, D; Bellani, G; Franzesi, C; Patelli, G; Besana, F; Costa, C; Vignali, L; Benatti, G; Sverzellati, N; Scarnecchia, E; Lombardo, F; Anastasio, F; Iannaccone, M; Vaudano, P; Pacielli, A; Baffoni, L; Gardi, I; Cesini, E; Sperandio, M; Micossi, C; De Carlini, C; Spreafico, C; Maggiolini, S; Bonaffini, P; Iacovoni, A; Sironi, S; Senni, M; Fominskiy, E; De Cobelli, F; Maggioni, A; Rapezzi, C; Ferrari, R; Colombo, A; Esposito, A
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/308478
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