Mortality Prognosis in COVID-19: Using Noncardiac Gated Thoracic CT

Mortality in patients with COVID-19 may be predicted with coronary and noncoronary cardiovascular findings on noncardiac gated thoracic computed tomography (CT), according to study findings published in Clinical Imaging.

There is no clear understanding of the possible impact of cardiovascular comorbidities among patients with SARS-CoV-2 infection. Researchers assessed the predictive power of coronary and noncoronary findings in patients infected by COVID-19. The primary outcome was in-hospital death.

Between December 2020 and February 2021, the researchers conducted a single-center, retrospective, observational study of 594 consecutive patients diagnosed and then hospitalized with COVID-19, who subsequently underwent noncardiac gated thoracic CT. Patient exclusions included coronary artery bypass surgery, aortic endograft, percutaneous coronary intervention, defibrillator implantation, heart valve surgery, pacemaker, or multiple trauma. Coronary artery calcification segment involvement score (CACSIS; measured from 0 to16, with 0 indicating absence of calcification and >5 indicating extensive coronary calcifications) and noncoronary atherosclerosis cardiovascular findings (NCACVF) were evaluated by blinded radiologists.

At a mean 8-day follow-up (4 to 12.5 days), there had been 44 deaths (7.4%). Nonsurvivors showed increased CACSIS compared with survivors (P <.001). Nonsurvivors also had significantly more major findings on NCACVF compared with survivors (29.5% vs 2.7%, respectively; P <.001) at this follow-up. A significant independent link with inhospital death was noted with multivariable analysis of age (P =.009), creatinine (P <.001), high sensitivity cardiac troponin T and I (P =.004), and NCACVF (HR 1.789; 95% CI, 1.053–3.037; P =.031).

Study limitations included the lack of nonhospitalized patients, small sample size, and lack of quantitative analysis of CACSIS and NCACVF images.

“Noncardiac gated thoracic CT scan is a cornerstone diagnostic tool for pulmonary involvement in SARS-CoV-2 infection,” the investigators concluded. “CACSIS and NCACVF, obtained from noncardiac gated thoracic CT scans, showed that these scores may help predict in-hospital mortality easily and quickly,” they added.

Reference

Celik AI, Bezgin T, Baytugan NZ, Coskun R, Karaaslan MB, Cagdas M. Role of the coronary and non-coronary cardiovascular findings on non-cardiac gated thoracic CT in predicting mortality in SARS-CoV-2 infection. Clin Imaging. Published online June 9, 2022. doi:10.1016/j.clinimag.2022.06.002