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Cardiovascular findings on chest computed tomography associated with COVID-19 adverse clinical outcomes
oleh: Maria Isabel Camara Planek, Max Ruge, Jeanne M. Du Fay de Lavallaz, Stella B. Kyung, Joanne Michelle D. Gomez, Tisha M. Suboc, Kim A. Williams, Annabelle Santos Volgman, J. Alan Simmons, Anupama K. Rao
Format: | Article |
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Diterbitkan: | Elsevier 2021-11-01 |
Deskripsi
Study objective: Chest computed tomography (chest CT) is routinely obtained to assess disease severity in COVID-19. While pulmonary findings are well-described in COVID-19, the implications of cardiovascular findings are less well understood. We evaluated the impact of cardiovascular findings on chest CT on the adverse composite outcome (ACO) of hospitalized COVID-19 patients. Setting/participants: 245 COVID-19 patients who underwent chest CT at Rush University Health System were included. Design: Cardiovascular findings, including coronary artery calcification (CAC), aortic calcification, signs of right ventricular strain [right ventricular to left ventricular diameter ratio, pulmonary artery to aorta diameter ratio, interventricular septal position, and inferior vena cava (IVC) reflux], were measured by trained physicians. Interventions/main outcome measures: These findings, along with pulmonary findings, were analyzed using univariable logistic analysis to determine the risk of ACO defined as intensive care admission, need for non-invasive positive pressure ventilation, intubation, in-hospital and 60-day mortality. Secondary endpoints included individual components of the ACO. Results: Aortic calcification was independently associated with an increased risk of the ACO (odds ratio 1.86, 95% confidence interval (1.11–3.17) p < 0.05). Aortic calcification, CAC, abnormal septal position, or IVC reflux of contrast were all significantly associated with 60-day mortality and major adverse cardiovascular events. IVC reflux was associated with in-hospital mortality (p = 0.005). Conclusion: Incidental cardiovascular findings on chest CT are clinically important imaging markers in COVID-19. It is important to ascertain and routinely report cardiovascular findings on CT imaging of COVID-19 patients as they have potential to identify high risk patients.