Predicting the outcome in confirmed COVID-19 patients with coronary artery disease: a key role for the first chest computed tomography

Abstract

Background Serial chest computed tomography (CT) scans are used to detect coronavirus disease 2019 (COVID-19) pneumonia and monitor the disease course. This study investigates relationship between total severity score by first chest CT and the outcome of coronavirus COVID-19 patients with coronary artery disease (CAD). Results A total of 48 patients with a history of CAD (mean age=60.83±3.06 years, 75% male) with positive real-time reverse transcription-polymerase chain reaction for COVID-19 were included. Outcome was defined as acute respiratory distress syndrome or death. The unadjusted and adjusted effects of the CT score on the outcome were reported through odds ratio (OR) with 95% confidence interval (CI). Outcome occurred in 17 (35.5%) patients (8 deaths). The CT score was directly and significantly correlated with the outcome in the univariate analysis (OR 1.38, 95% CI 1.12–1.70; P=0.003) and remained significant after adjustment for diabetes, hypertension, body mass index, and serum level of highly sensitive C-reactive protein (OR 1.51, 95% CI 1.11–2.05; P=0.009). Outcome rate was 24.1% in patients with a CT score <2.5, whereas it was 8.3% in patients with a CT score>2.5. Conclusions The first chest CT score could be a robust predictor of adverse events in confirmed COVID-19 patients with coronary artery disease.

Myocardial Infarction in Patients with and without COVID-19: Comparisons of Characteristics, Clinical Courses, and Outcomes

“…The following laboratory tests and medical interventions exhibit a rise or test positive due to COVID-19 in patients with MI: CRP, the erythrocyte sedimentation rate, leukocytosis, and intubation. 6 …”

“…Coronary heart disease can exacerbate the clinical course and outcome of patients with COVID-19. 6 , 7 The coexistence of these 2 acute diseases can affect the outcome of MI in several ways, including delays in referral due to the fear of COVID-19 infection and delays in diagnosis due to the similarity of laboratory findings and symptoms (eg, shortness of breath, chest pain, positive troponin, and electrocardiographic [ECG] changes). 8 – 10 Recent studies have indicated that although the most significant emphasis on the COVID-19 disease is on pulmonary complications, physicians need to be aware of cardiovascular complications.…”