TY  - JOUR
A1  - Koch, Vitali
A1  - Grünewald, Leon David
A1  - Albrecht, Moritz Hans Ernst
A1  - Eichler, Katrin
A1  - Gruber-Rouh, Tatjana
A1  - Yel, Ibrahim
A1  - Alizadeh, Leona Soraja
A1  - Mahmoudi, Scherwin
A1  - Scholtz, Jan-Erik
A1  - Martin, Simon S.
A1  - Lenga, Lukas
A1  - Vogl, Thomas J.
A1  - Mohammed, Nour-Eldin Abdelrehim Nour-Eldin
A1  - Bienenfeld, Florian
A1  - Hammerstingl, Renate Maria
A1  - Graf, Christiana
A1  - Sommer, Christof M.
A1  - Hardt, Stefan
A1  - Mazziotti, Silvio
A1  - Ascenti, Giorgio
A1  - Versace, Giovanni Antonio
A1  - D’Angelo, Tommaso
A1  - Booz, Christian
T1  - Lung opacity and coronary artery calcium score: a combined tool for risk stratification and outcome prediction in COVID-19 patients
T2  - Academic radiology
N2  - Highlights
• Assessment of coronary artery plaque burden according to the CAC-DRS Score correlated well with pulmonary involvement of SARS-CoV-2 pneumonia (min. r=0.81, 95% CI 0.76 to 0.86).
• Visual and quantitative CAC-DRS Score of coronary artery plaque burden provided independent prognostic information on all-cause mortality in patients with SARS-CoV-2 pneumonia (p=0.0016 and p<0.0001, respectively).
• Incorporating CAC-DRS Score and pulmonary involvement into clinical decision making revealed great potential to discriminate patients with fatal outcomes from a mild course of disease (AUC 0.938, 95% CI 0.89 to 0.97) and the need for intensive care treatment (AUC 0.801, 95% CI 0.77 to 0.83).

Purpose: To assess and correlate pulmonary involvement and outcome of SARS-CoV-2 pneumonia with the degree of coronary plaque burden based on the CAC-DRS classification (Coronary Artery Calcium Data and Reporting System).
Methods: This retrospective study included 142 patients with confirmed SARS-CoV-2 pneumonia (58 ± 16 years; 57 women) who underwent non-contrast CT between January 2020 and August 2021 and were followed up for 129 ± 72 days. One experienced blinded radiologist analyzed CT series for the presence and extent of calcified plaque burden according to the visual and quantitative HU-based CAC-DRS Score. Pulmonary involvement was automatically evaluated with a dedicated software prototype by another two experienced radiologists and expressed as Opacity Score.
Results: CAC-DRS Scores derived from visual and quantitative image evaluation correlated well with the Opacity Score (r=0.81, 95% CI 0.76-0.86, and r=0.83, 95% CI 0.77-0.89, respectively; p<0.0001) with higher correlation in severe than in mild stage SARS-CoV-2 pneumonia (p<0.0001). Combined, CAC-DRS and Opacity Scores revealed great potential to discriminate fatal outcomes from a mild course of disease (AUC 0.938, 95% CI 0.89-0.97), and the need for intensive care treatment (AUC 0.801, 95% CI 0.77-0.83). Visual and quantitative CAC-DRS Scores provided independent prognostic information on all-cause mortality (p=0.0016 and p<0.0001, respectively), both in univariate and multivariate analysis.
Conclusions: Coronary plaque burden is strongly correlated to pulmonary involvement, adverse outcome, and death due to respiratory failure in patients with SARS-CoV-2 pneumonia, offering great potential to identify individuals at high risk.
KW  - Coronary Plaque Burden
KW  - CAC-DRS Score
KW  - SARS-CoV-2 Pneumonia
KW  - Coronary Heart Disease
KW  - Computed Tomography
Y1  - 2022
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/78329
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-783294
SN  - 1076-6332
VL  - 29
IS  - 6
SP  - 861
EP  - 870
PB  - Elsevier
CY  - Amsterdam
ER  -