Abstract 13883: The Presence of Coronary Calcifications on the Chest CT Scan Performed to Diagnose Covid-19 is Associated With a Worse Prognosis

Abstract

Introduction: With the coronavirus disease (COVID-19) outbreak, early identification of the most severely impacted patients is essential. Previous cardiovascular (CV) and metabolic diseases affect the COVID-19 prognosis. In high CV risk patients, coronary artery calcification (CAC) is associated with a higher incidence of CV outcomes. Hypothesis: To assess the association between the presence of CAC on the chest CT performed to diagnose COVID-19 and the occurrence of severe COVID-19 outcomes. Methods: Cross-sectional study on consecutive patients from 40 to 80 years of age, hospitalized for COVID-19 infection, with a chest CT without contrast injection performed on the day of admission. Patients with CV disease history were excluded. CAC was defined as any area ≥1mm2 with a density >130 Hounsfield units on the known coronary track. The primary outcome was the rate of patients with severe progression, defined as a score of 5 to 7 on the WHO Blueprint expert group scale (noninvasive or invasive mechanical ventilation, extracorporeal membrane oxygenation, death) within 8 days following hospital admission. Results: 134 consecutive patients (60±8 years) were included. CAC was detected in 61 patients (46%). The primary outcome occurred in 29 (48%) of those 61 patients with CAC compared to 15 (21%) without CAC (HR 2.9; 95% CI [1.6 - 5.3]; p=0.0008). In patients ≤60 years (n=69), CAC was detected in 28% and the primary outcome occurred in 58% of patients with CAC compared to 16% without CAC (p=0.0006). In patients >60 years (n=65), CAC was detected in 63% of patients. In this population, the primary outcome occurred in 43% of patients with CAC compared to 30% without CAC without significant interaction. Multivariate analysis showed that CAC was independently associated with poor prognosis (HR 3.4; 95% CI [1.5 - 7.8]; p= 0.004). Conclusions: The evidence of CAC on initial chest CT performed in patients with COVID-19 is associated with a worse prognosis.