Coronary calcifications on non-gated chest CT in COVID-19 patients: prevalence and impact on outcomes

Abstract

Introduction: Recent studies have demonstrated the complex interplay between COVID-19 infection, cardiovascular disease, and poor outcomes. In this context, the evaluation of coronary artery calcifications (CAC) may provide additional risk stratification in COVID-19 patients.

Methods: We retrospectively enrolled 105 consecutive COVID-19 patients who underwent non-gated chest CT at our department from April to July 2020. CAC were assessed by two independent observers and graded as absent, mild, moderate, and severe. Clinical files were checked for basic demographic variables, C-reactive protein at admission, number of hospitalization days, need for ventilatory support and death. Original CT reports were checked for mention of CAC.

Results: Sixty-six patients had CAC on chest CT. Patients with any CAC were more likely to need ventilatory support (OR: 3,6) and die (OR: 8,9). Patients with severe CAC were more likely to need ventilatory support (OR: 4,1) and with moderate CAC more likely to die (OR: 11,1). Patients with CAC had longer hospitalizations (mean: 18,5 days) than patients without CAC (mean: 12,4 days, p=0,038). Original radiological reports included CAC in only 22 (21%) of patients, but 12 (52,2%) of the severe CAC were included in the report.

Conclusion: CAC are associated with a worse prognosis in COVID patients and may be used as an additional risk stratification tool in this patient population. CAC should be reported whenever visible.