Coronary arteries and aortic valve calcifications in COVID-19: Not only lungs at chest CT

Abstract

Objectives: Cardiovascular diseases cause worse outcomes in patients affected by COVID-19. High coronary artery calcium score (CACS) and aortic valve calcifications (AC) increase cardiovascular risk. Our purpose is to evaluate CACS, measured by Weston Score (WS), and presence of AC in chest CT of COVID-19 patients and possibly to investigate their prognostic role. Material and methods: This retrospective case-control study includes 150 hospitalized COVID-19 patients who underwent a chest CT at admission. The case group (Group A) was formed by 50 in-patients in Intensive Care Unit (ICU) under invasive ventilation (IV), while the matching control group for sex, age and BMI (Group B) was formed by 100 in-patients in non-ICU units, not under IV. After, a second case-control selection was originated from these two Groups: the case group (Group A1) composed by 30 patients selected from Group A, and the matching control group for age, sex, BMI and CT lung severity score (LSS) (Group B1) composed by 60 patients selected from Group B. WS and the presence of AC were compared between Groups A and B, and between Groups A1 and B1. Moreover, LSS and WS were correlated. Parametric tests were used for statistical analysis. Material and methods: This retrospective case-control study includes 150 hospitalized COVID-19 patients who underwent a chest CT at admission. The case group (Group A) was formed by 50 in-patients in Intensive Care Unit (ICU) under invasive ventilation (IV), while the matching control group for sex, age and BMI (Group B) was formed by 100 in-patients in non-ICU units, not under IV. After, a second case-control selection was originated from these two Groups: the case group (Group A1) composed by 30 patients selected from Group A, and the matching control group for age, sex, BMI and CT lung severity score (LSS) (Group B1) composed by 60 patients selected from Group B. WS and the presence of AC were compared between Groups A and B, and between Groups A1 and B1. Moreover, LSS and WS were correlated. Parametric tests were used for statistical analysis. Results: Among the 150 patients, 105 (70.0%) were male and 45 (30.0%) female. The age was 70.2 ± 13.3 years. LSS was 7.5 ± 3.9, WS was 6.4 ± 3.0; AC was present in 97/150 (64.7%). WS was significantly higher in Group A than in Group B, respectively, 7.4 ± 4.0 and 5.7 ± 2.6 (p=0.0146), and also the presence of AC, respectively, 41/50 (82.0%) vs 56/100 (56.0%) (p=0.0016). In Group B, LSS and WS had a linear positive correlation (r=0.2240, p=0.0405). Finally, WS and AC were significantly higher in Group A1 compared to Group B1. Conclusions: Both WS and AC were higher in ICU COVID-19 patients than in non-ICU COVID-19 patients: they could have a predictive role in the pejorative evolution of the disease.