tetano
Editor, Senior Moderator
J Thorac Imaging
. 2022 Apr 13.
doi: 10.1097/RTI.0000000000000648. Online ahead of print.
Coronary Artery Calcifications Are Associated With More Severe Multiorgan Failure in Patients With Severe Coronavirus Disease 2019 Infection: Longitudinal Results of the Maastricht Intensive Care COVID Cohort
Bibi Martens[SUP] 1 2 [/SUP], Rob G H Driessen[SUP] 3 4 2 [/SUP], Lloyd Brandts[SUP] 5 [/SUP], Puck Hoitinga[SUP] 3 [/SUP], Fauve van Veen[SUP] 3 [/SUP], Mariëlle Driessen[SUP] 3 [/SUP], Vanessa Weberndörfer[SUP] 4 2 [/SUP], Bas Kietselaer[SUP] 6 [/SUP], Chahinda Ghossein-Doha[SUP] 3 2 7 6 [/SUP], Hester A Gietema[SUP] 1 7 [/SUP], Kevin Vernooy[SUP] 4 [/SUP], Iwan C C van der Horst[SUP] 3 2 [/SUP], Joachim E Wildberger[SUP] 1 2 [/SUP], Bas C T van Bussel[SUP] 3 8 [/SUP], Casper Mihl[SUP] 1 2 [/SUP], MaastrICCht Collaborators
Affiliations
Abstract
Purpose: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is regarded as a multisystemic disease. Patients with preexisting cardiovascular disease have an increased risk for a more severe disease course. This study aimed to investigate if a higher degree of coronary artery calcifications (CAC) on a standard chest computed tomography (CT) scan in mechanically ventilated patients was associated with a more severe multiorgan failure over time.
Materials and methods: All mechanically ventilated intensive care unit patients with SARS-CoV-2 infection who underwent a chest CT were prospectively included. CT was used to establish the extent of CAC using a semiquantitative grading system. We categorized patients into 3 sex-specific tertiles of CAC: lowest, intermediate, and highest CAC score. Daily, the Sequential Organ Failure Assessment (SOFA) scores were collected to evaluate organ failure over time. Linear mixed-effects regression was used to investigate differences in SOFA scores between tertiles. The models were adjusted for age, sex, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, cardiovascular risk factors, and chronic liver, lung, and renal disease.
Results: In all, 71 patients were included. Patients in the highest CAC tertile had, on average, over time, 1.8 (0.5-3.1) points higher SOFA score, compared with the lowest CAC tertile (P=0.005). This association remained significant after adjustment for age, sex, and APACHE II score (1.4 [0.1-2.7],P=0.042) and clinically relevant after adjustment for cardiovascular risk factors (1.3 [0.0-2.7],P=0.06) and chronic diseases (1.3 [-0.2 to 2.7],P=0.085).
Conclusion: A greater extent of CAC is associated with a more severe multiorgan failure in mechanically ventilated coronavirus disease 2019 patients.
. 2022 Apr 13.
doi: 10.1097/RTI.0000000000000648. Online ahead of print.
Coronary Artery Calcifications Are Associated With More Severe Multiorgan Failure in Patients With Severe Coronavirus Disease 2019 Infection: Longitudinal Results of the Maastricht Intensive Care COVID Cohort
Bibi Martens[SUP] 1 2 [/SUP], Rob G H Driessen[SUP] 3 4 2 [/SUP], Lloyd Brandts[SUP] 5 [/SUP], Puck Hoitinga[SUP] 3 [/SUP], Fauve van Veen[SUP] 3 [/SUP], Mariëlle Driessen[SUP] 3 [/SUP], Vanessa Weberndörfer[SUP] 4 2 [/SUP], Bas Kietselaer[SUP] 6 [/SUP], Chahinda Ghossein-Doha[SUP] 3 2 7 6 [/SUP], Hester A Gietema[SUP] 1 7 [/SUP], Kevin Vernooy[SUP] 4 [/SUP], Iwan C C van der Horst[SUP] 3 2 [/SUP], Joachim E Wildberger[SUP] 1 2 [/SUP], Bas C T van Bussel[SUP] 3 8 [/SUP], Casper Mihl[SUP] 1 2 [/SUP], MaastrICCht Collaborators
Affiliations
- PMID: 35412497
- DOI: 10.1097/RTI.0000000000000648
Abstract
Purpose: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is regarded as a multisystemic disease. Patients with preexisting cardiovascular disease have an increased risk for a more severe disease course. This study aimed to investigate if a higher degree of coronary artery calcifications (CAC) on a standard chest computed tomography (CT) scan in mechanically ventilated patients was associated with a more severe multiorgan failure over time.
Materials and methods: All mechanically ventilated intensive care unit patients with SARS-CoV-2 infection who underwent a chest CT were prospectively included. CT was used to establish the extent of CAC using a semiquantitative grading system. We categorized patients into 3 sex-specific tertiles of CAC: lowest, intermediate, and highest CAC score. Daily, the Sequential Organ Failure Assessment (SOFA) scores were collected to evaluate organ failure over time. Linear mixed-effects regression was used to investigate differences in SOFA scores between tertiles. The models were adjusted for age, sex, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, cardiovascular risk factors, and chronic liver, lung, and renal disease.
Results: In all, 71 patients were included. Patients in the highest CAC tertile had, on average, over time, 1.8 (0.5-3.1) points higher SOFA score, compared with the lowest CAC tertile (P=0.005). This association remained significant after adjustment for age, sex, and APACHE II score (1.4 [0.1-2.7],P=0.042) and clinically relevant after adjustment for cardiovascular risk factors (1.3 [0.0-2.7],P=0.06) and chronic diseases (1.3 [-0.2 to 2.7],P=0.085).
Conclusion: A greater extent of CAC is associated with a more severe multiorgan failure in mechanically ventilated coronavirus disease 2019 patients.