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Calcification of the thoracic aorta on low-dose chest CT predicts severe COVID-19
BACKGROUND: Cardiovascular comorbidity anticipates poor prognosis of SARS-CoV-2 disease (COVID-19) and correlates with the systemic atherosclerotic transformation of the arterial vessels. The amount of aortic wall calcification (AWC) can be estimated on low-dose chest CT. We suggest quantification o...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7757863/ https://www.ncbi.nlm.nih.gov/pubmed/33362199 http://dx.doi.org/10.1371/journal.pone.0244267 |
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author | Fervers, Philipp Kottlors, Jonathan Zopfs, David Bremm, Johannes Maintz, David Safarov, Orkhan Tritt, Stephanie Abdullayev, Nuran Persigehl, Thorsten |
author_facet | Fervers, Philipp Kottlors, Jonathan Zopfs, David Bremm, Johannes Maintz, David Safarov, Orkhan Tritt, Stephanie Abdullayev, Nuran Persigehl, Thorsten |
author_sort | Fervers, Philipp |
collection | PubMed |
description | BACKGROUND: Cardiovascular comorbidity anticipates poor prognosis of SARS-CoV-2 disease (COVID-19) and correlates with the systemic atherosclerotic transformation of the arterial vessels. The amount of aortic wall calcification (AWC) can be estimated on low-dose chest CT. We suggest quantification of AWC on the low-dose chest CT, which is initially performed for the diagnosis of COVID-19, to screen for patients at risk of severe COVID-19. METHODS: Seventy consecutive patients (46 in center 1, 24 in center 2) with parallel low-dose chest CT and positive RT-PCR for SARS-CoV-2 were included in our multi-center, multi-vendor study. The outcome was rated moderate (no hospitalization, hospitalization) and severe (ICU, tracheal intubation, death), the latter implying a requirement for intensive care treatment. The amount of AWC was quantified with the CT vendor's software. RESULTS: Of 70 included patients, 38 developed a moderate, and 32 a severe COVID-19. The average volume of AWC was significantly higher throughout the subgroup with severe COVID-19, when compared to moderate cases (771.7 mm(3) (Q1 = 49.8 mm(3), Q3 = 3065.5 mm(3)) vs. 0 mm(3) (Q1 = 0 mm(3), Q3 = 57.3 mm(3))). Within multivariate regression analysis, including AWC, patient age and sex, as well as a cardiovascular comorbidity score, the volume of AWC was the only significant regressor for severe COVID-19 (p = 0.004). For AWC > 3000 mm(3), the logistic regression predicts risk for a severe progression of 0.78. If there are no visually detectable AWC risk for severe progression is 0.13, only. CONCLUSION: AWC seems to be an independent biomarker for the prediction of severe progression and intensive care treatment of COVID-19 already at the time of patient admission to the hospital; verification in a larger multi-center, multi-vendor study is desired. |
format | Online Article Text |
id | pubmed-7757863 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-77578632021-01-06 Calcification of the thoracic aorta on low-dose chest CT predicts severe COVID-19 Fervers, Philipp Kottlors, Jonathan Zopfs, David Bremm, Johannes Maintz, David Safarov, Orkhan Tritt, Stephanie Abdullayev, Nuran Persigehl, Thorsten PLoS One Research Article BACKGROUND: Cardiovascular comorbidity anticipates poor prognosis of SARS-CoV-2 disease (COVID-19) and correlates with the systemic atherosclerotic transformation of the arterial vessels. The amount of aortic wall calcification (AWC) can be estimated on low-dose chest CT. We suggest quantification of AWC on the low-dose chest CT, which is initially performed for the diagnosis of COVID-19, to screen for patients at risk of severe COVID-19. METHODS: Seventy consecutive patients (46 in center 1, 24 in center 2) with parallel low-dose chest CT and positive RT-PCR for SARS-CoV-2 were included in our multi-center, multi-vendor study. The outcome was rated moderate (no hospitalization, hospitalization) and severe (ICU, tracheal intubation, death), the latter implying a requirement for intensive care treatment. The amount of AWC was quantified with the CT vendor's software. RESULTS: Of 70 included patients, 38 developed a moderate, and 32 a severe COVID-19. The average volume of AWC was significantly higher throughout the subgroup with severe COVID-19, when compared to moderate cases (771.7 mm(3) (Q1 = 49.8 mm(3), Q3 = 3065.5 mm(3)) vs. 0 mm(3) (Q1 = 0 mm(3), Q3 = 57.3 mm(3))). Within multivariate regression analysis, including AWC, patient age and sex, as well as a cardiovascular comorbidity score, the volume of AWC was the only significant regressor for severe COVID-19 (p = 0.004). For AWC > 3000 mm(3), the logistic regression predicts risk for a severe progression of 0.78. If there are no visually detectable AWC risk for severe progression is 0.13, only. CONCLUSION: AWC seems to be an independent biomarker for the prediction of severe progression and intensive care treatment of COVID-19 already at the time of patient admission to the hospital; verification in a larger multi-center, multi-vendor study is desired. Public Library of Science 2020-12-23 /pmc/articles/PMC7757863/ /pubmed/33362199 http://dx.doi.org/10.1371/journal.pone.0244267 Text en © 2020 Fervers et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Fervers, Philipp Kottlors, Jonathan Zopfs, David Bremm, Johannes Maintz, David Safarov, Orkhan Tritt, Stephanie Abdullayev, Nuran Persigehl, Thorsten Calcification of the thoracic aorta on low-dose chest CT predicts severe COVID-19 |
title | Calcification of the thoracic aorta on low-dose chest CT predicts severe COVID-19 |
title_full | Calcification of the thoracic aorta on low-dose chest CT predicts severe COVID-19 |
title_fullStr | Calcification of the thoracic aorta on low-dose chest CT predicts severe COVID-19 |
title_full_unstemmed | Calcification of the thoracic aorta on low-dose chest CT predicts severe COVID-19 |
title_short | Calcification of the thoracic aorta on low-dose chest CT predicts severe COVID-19 |
title_sort | calcification of the thoracic aorta on low-dose chest ct predicts severe covid-19 |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7757863/ https://www.ncbi.nlm.nih.gov/pubmed/33362199 http://dx.doi.org/10.1371/journal.pone.0244267 |
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