Coronary artery calcium score predicts outcome in patients with COVID-19

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Aim Coronary artery calcium (CAC) score is a proven prognostic marker of cardiovascular risk. The aim of this study was to evaluate the prognostic value of CAC score on standard chest computed tomography (CT) in patients admitted with COVID-19. Methods We enrolled 144 consecutive patients (mean age 67± 13, 60.7% male) hospitalized with COVID-19, who on admission underwent chest CT to detect and assess pulmonary involvement. CAC score was calculated by two investigators blinded to patients clinical data. Patients were followed-up for 12 months after their admission. Results 106 patients had image quality sufficient for analysis. The median CAC score was 249 Agatston units (interquartile range 658). 33 deaths were recorded in the study group during the follow-up period. The median values of CAC of patients who died during the study period and of the survivors were 592 (interquartile range 1492) and 142 (interquartile range 400), respectively. The difference in CAC between these two subgroups was statistically significant (p = 0,0001). The area under the ROC curve for CAC score for predicting all-cause mortality was 0.738 (95% CI 0,644 to 0,819). The criterion with the highest prognostic accuracy was CAC score >143 Agatston units (positive and negative predictive values were 44,4% and 88,4%, respectively). The presence of this criterion was associated with 3,82 times higher relative risk of mortality (95%CI 1.60 – 9,11; p = 0.0025). Conclusion CAC score measurement based on standard chest CT performed on admission in patients with COVID-19 to detect pulmonary involvement is a prognostic marker of increased mortality during the 12-month follow-up.