Coronary calcifications as a new prognostic marker in COVID-19 patients: role of CT

Abstract. – OBJECTIVE: COVID-19 pneumo nia, caused by the virus Severe Acute Respira tory Syndrome Coronavirus-2 (SARS-CoV-2), was declared a pandemic by the WHO on 11th March 2020. While Reverse Transcriptase Poly merase Chain Reaction (RT-PCR) represents the diagnostic gold standard of infection, com puted tomography (CT) has been shown to have an important role in supporting the diag nosis, quantifying the severity, and assessing the efficacy of treatment and its response. Cor onary artery calcification (CAC) is a CT find ing that estimates atherosclerosis and can be quantified using the coronary artery calcium score (CACS). The purpose of this study is to demonstrate the correlation between coro nary artery calcification and mortality rate in COVID-19 patients. PATIENTS AND METHODS: Three hun dred seventeen (317) hospitalized patients with SARS-CoV-2 infection were ruled in this retro spective study. All patients underwent a non ECG-gated chest CT to evaluate lung parenchy mal involvement. In the same cohort, we ob served the two main coronary arteries (common trunk, circumflex, anterior interventricular and right coronary heart) using a visual score, so patients were divided into four groups based on Ordinal CAC Score (OCS) levels. RESULTS: The multivariate analysis proved that the OCS value was statistically correlat ed with the mortality rate (p < 0.001). In fact, in the group of patients with an OCS value of 0, the mortality rate was 10.1% (10/99 patients), in the group with OCS between 1 and 4 was 18.9% (21/111), in the OCS group of patients ranged from 5 to 8 was 30.4% (24/79) and in the OCS group between 9 and 12 was 46.4% (13/28). CONCLUSIONS: We suggest that calcific ath eromasia of the coronary arteries in patients with COVID-19 can be considered a prognostic marker of clinical outcome