Vitali Koch, Leon David Grünewald, Moritz Hans Ernst Albrecht, Katrin Eichler, Tatjana Gruber-Rouh, Ibrahim Yel, Leona Soraja Alizadeh, Scherwin Mahmoudi, Jan-Erik Scholtz, Simon S. Martin, Lukas Lenga, Thomas J. Vogl, Nour-Eldin Abdelrehim Nour-Eldin Mohammed, Florian Bienenfeld, Renate Maria Hammerstingl, Christiana Graf, Christof M. Sommer, Stefan Hardt, Silvio Mazziotti, Giorgio Ascenti, Giovanni Antonio Versace, Tommaso D’Angelo, Christian Booz
- 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.
MetadatenAuthor: | Vitali KochORCiDGND, Leon David GrünewaldORCiDGND, Moritz Hans Ernst AlbrechtORCiDGND, Katrin EichlerGND, Tatjana Gruber-RouhORCiDGND, Ibrahim YelORCiDGND, Leona Soraja AlizadehORCiDGND, Scherwin MahmoudiORCiDGND, Jan-Erik ScholtzGND, Simon S. MartinORCiDGND, Lukas LengaORCiDGND, Thomas J. VoglORCiDGND, Nour-Eldin Abdelrehim Nour-Eldin MohammedORCiDGND, Florian Bienenfeld, Renate Maria HammerstinglGND, Christiana GrafORCiDGND, Christof M. SommerORCiDGND, Stefan HardtORCiDGND, Silvio MazziottiORCiD, Giorgio AscentiORCiD, Giovanni Antonio VersaceORCiD, Tommaso D’AngeloORCiD, Christian BoozORCiDGND |
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URN: | urn:nbn:de:hebis:30:3-783294 |
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DOI: | https://doi.org/10.1016/j.acra.2022.02.019 |
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ISSN: | 1076-6332 |
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Parent Title (English): | Academic radiology |
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Publisher: | Elsevier |
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Place of publication: | Amsterdam |
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Document Type: | Article |
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Language: | English |
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Date of Publication (online): | 2022/05/02 |
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Date of first Publication: | 2022/02/28 |
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Publishing Institution: | Universitätsbibliothek Johann Christian Senckenberg |
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Release Date: | 2024/08/22 |
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Tag: | CAC-DRS Score; Computed Tomography; Coronary Heart Disease; Coronary Plaque Burden; SARS-CoV-2 Pneumonia |
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Volume: | 29 |
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Issue: | 6 |
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Page Number: | 10 |
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First Page: | 861 |
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Last Page: | 870 |
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Institutes: | Medizin |
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Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
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Sammlungen: | Universitätspublikationen |
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Licence (German): | Creative Commons - CC BY - Namensnennung 4.0 International |
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