Introduction: Even more than a year after the pandemic began with the new coronavirus, the number of deaths due to the disease continues to increase. Knowing the risk factors for poor outcomes are extremely important to prevent future deaths.The present study aimed to evaluate the potential role of coronary calcification (CAC) as a risk factor for death or mechanical ventilation of patients with Covid-19.
Methods: We evaluated 615 patients admitted to hospital with acute respiratory symptoms with high-resolution chest computed tomography (CT scan). CAC was evaluated and classified by the number of affected coronary segments. Among them, 283 patients met the criteria for Covid-19 infection (RT-PCR positive and/or typical clinical and chest imaging presentation).
Results: The mean age was 58.7 ± 15.7 years and 54.1% were men. Patients with CAC were older, more likely to have hypertension and less likely to be obese. CAC was present in 75 patients (26.5%), of which 42 had a score between 1-3 (mild) and 33 had severe presentation (score > 3) and was associated with death (OR 2.35, 95% CI 1.01- 5.48) and mechanical ventilation (OR 2.72, 95% CI 1.20-6.20) adjusted for multiple confounders, with significant and increased odds ratio for the severe form of CAC (death: OR 3.70, 95% CI 1.20-11.42; mechanical ventilation: OR 3.30, 95% CI 1.09-9.95).
Conclusions: CAC was an independent risk factor for mechanical ventilation and death in patients infected with SARS-CoV-2, particularly for those with severe calcifications. CAC can be easily characterized on usual chest CT scan of patients, who usually use this method in the diagnostic process of moderate to severe Covid-19.
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