TY - JOUR
T1 - Coronary Artery Calcifications Are Associated With More Severe Multiorgan Failure in Patients With Severe Coronavirus Disease 2019 Infection
T2 - Longitudinal Results of the Maastricht Intensive Care COVID Cohort
AU - Martens, Bibi
AU - Driessen, Rob G H
AU - Brandts, Lloyd
AU - Hoitinga, Puck
AU - van Veen, Fauve
AU - Driessen, Mariëlle
AU - Weberndörfer, Vanessa
AU - Kietselaer, Bas
AU - Ghossein-Doha, Chahinda
AU - Gietema, Hester A
AU - Vernooy, Kevin
AU - van der Horst, Iwan C C
AU - Wildberger, Joachim E
AU - van Bussel, Bas C T
AU - Mihl, Casper
AU - MaastrICCht Collaborators
N1 - Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.
PY - 2022/7
Y1 - 2022/7
N2 - 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.
AB - 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.
KW - ACUTE PHYSIOLOGY
KW - APACHE
KW - COMPUTED-TOMOGRAPHY
KW - FRAMINGHAM-STUDY INSIGHTS
KW - GUIDELINES
KW - SCORE
KW - Sequential Organ Failure Assessment score
KW - computed tomography
KW - coronary artery disease
KW - coronary calcium
KW - coronavirus disease 2019
KW - multiorgan failure
U2 - 10.1097/RTI.0000000000000648
DO - 10.1097/RTI.0000000000000648
M3 - Article
C2 - 35412497
SN - 0883-5993
VL - 37
SP - 217
EP - 224
JO - Journal of Thoracic Imaging
JF - Journal of Thoracic Imaging
IS - 4
ER -