Cardiovascular findings on chest computed tomography associated with COVID-19 adverse clinical outcomes
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 che...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-11-01
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| Series: | American Heart Journal Plus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666602221000501 |
| _version_ | 1811329248060768256 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Maria Isabel Camara Planek |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-13T15:40:27Z |
| format | Article |
| id | doaj.art-02bc4a9a76c843e595b192db5ac4d51f |
| institution | Directory Open Access Journal |
| issn | 2666-6022 |
| language | English |
| last_indexed | 2024-04-13T15:40:27Z |
| publishDate | 2021-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Heart Journal Plus |
| spelling | doaj.art-02bc4a9a76c843e595b192db5ac4d51f2022-12-22T02:41:10ZengElsevierAmerican Heart Journal Plus2666-60222021-11-0111100052Cardiovascular findings on chest computed tomography associated with COVID-19 adverse clinical outcomesMaria Isabel Camara Planek0Max Ruge1Jeanne M. Du Fay de Lavallaz2Stella B. Kyung3Joanne Michelle D. Gomez4Tisha M. Suboc5Kim A. Williams6Annabelle Santos Volgman7J. Alan Simmons8Anupama K. Rao9Department of Internal Medicine, Rush University Medical Center, Chicago, IL, United States of America; Corresponding author at: Rush University Medical Center, 1700 W. Van Buren St., Chicago, IL 60612, United States of America.Department of Internal Medicine, Thomas Jefferson University, Philadelphia, PA, United States of AmericaDivision of Cardiology, Rush University Medical Center, Chicago, IL, United States of AmericaDivision of Cardiology, Loyola University Medical Center, Chicago, IL, United States of AmericaDivision of Cardiology, Rush University Medical Center, Chicago, IL, United States of AmericaDivision of Cardiology, Rush University Medical Center, Chicago, IL, United States of AmericaDivision of Cardiology, Rush University Medical Center, Chicago, IL, United States of AmericaDivision of Cardiology, Rush University Medical Center, Chicago, IL, United States of AmericaDepartment of Research Core, Rush University Medical Center, Chicago, IL, United States of AmericaDivision of Cardiology, Rush University Medical Center, Chicago, IL, United States of AmericaStudy 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.http://www.sciencedirect.com/science/article/pii/S2666602221000501Chest computed tomographyCOVID-19Aortic calcificationCoronary artery calcificationRight ventricular strain |
| spellingShingle | 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 Cardiovascular findings on chest computed tomography associated with COVID-19 adverse clinical outcomes American Heart Journal Plus Chest computed tomography COVID-19 Aortic calcification Coronary artery calcification Right ventricular strain |
| title | Cardiovascular findings on chest computed tomography associated with COVID-19 adverse clinical outcomes |
| title_full | Cardiovascular findings on chest computed tomography associated with COVID-19 adverse clinical outcomes |
| title_fullStr | Cardiovascular findings on chest computed tomography associated with COVID-19 adverse clinical outcomes |
| title_full_unstemmed | Cardiovascular findings on chest computed tomography associated with COVID-19 adverse clinical outcomes |
| title_short | Cardiovascular findings on chest computed tomography associated with COVID-19 adverse clinical outcomes |
| title_sort | cardiovascular findings on chest computed tomography associated with covid 19 adverse clinical outcomes |
| topic | Chest computed tomography COVID-19 Aortic calcification Coronary artery calcification Right ventricular strain |
| url | http://www.sciencedirect.com/science/article/pii/S2666602221000501 |
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