A Meta-Analysis: Coronary Artery Calcium Score and COVID-19 Prognosis

Abstract

Background: Multiple studies have investigated the correlations of mortality, mechanical ventilation, and intensive care unit (ICU) admissions with CAC scores. This analysis overviews the prognostic capability of CAC scoring in mortality, mechanical ventilation, and ICU admission for hospitalized COVID-19 patients. Methods: Online search was conducted on PubMed, Cochrane Library, and Scopus from inception to 22 November 2021 to identify studies involving CAC scores in relation to ICU admission, mechanical ventilation, and death rates. Results: A total of eight studies were analyzed. In the absence of CAC group compared with the presence of CAC score, there was an increase in mortality in the presence of CAC (RR 2.24, 95% CI, 1.41–3.56; p < 0.001). In the low CAC group and high CAC group, high CAC group had increase in mortality (RR 2.74; 95% CI, 1.94–3.86; p < 0.00001). There was no statistical difference in outcomes of mechanical ventilation and ICU admission between any of the groups. Conclusion: This meta-analysis strictly examined the outcomes of interest in death, mechanical ventilation, and ICU admission while comparing the CAC scores in patients with COVID-19. Given these findings, CAC scoring can aid in stratifying patients, thus allowing earlier interventions in rapidly developing illnesses.

A composite ranking of risk factors for COVID-19 time-to-event data from a Turkish cohort

“…By a literature search, we found all our selected factors were addressed in other studies and were shown to be significantly associated with the COVID-19 disease severity. Here is a partial summary: Low calcium level is associated with poor prognosis of COVID-19 ( Filippo et al, 2020 , Liu et al, 2020 , Lee et al, 2022 , probably due to its role in viral infection and replication. Higher neutrophil/lymphocyte ratio (NLR) is known to be associated with severity of COVID-19 ( Zhang et al, 2020 , Ma et al, 2020 , Ulgen et al, 2021 .…”

“…Low calcium level is associated with poor prognosis of COVID-19 ( Filippo et al, 2020 , Liu et al, 2020 , Lee et al, 2022 , probably due to its role in viral infection and replication.…”

Role of Endomyocardial Biopsy in Diagnostics of Myocarditis

“…Other reviews mentioned signs of cardiac injury caused by exacerbations of preexisting conditions resulting in myocardial ischemia [ 64 , 66 ]. The role of hypoperfusion-related cardiac injury was supported by a review of coronary artery calcium score impact on mortality rates in COVID-19 patients, finding a two-fold increase in patients with a higher score [ 69 ]. Pediatric reviews showed a high incidence of clinically suspected myocarditis in children presenting with multisystem inflammatory syndrome [ 70 , 71 , 72 , 73 ].…”

“…Objective findings highlight the hypothesis of a virus-triggered hyperinflammatory response [ 63 , 64 , 65 , 66 , 67 , 68 ]. This assumption is complemented by a high incidence of clinically suspected myocarditis in pediatric multisystem inflammatory syndrome [ 50 , 70 , 71 , 72 , 73 ] and autopsy findings of cardiac injury being a consequence of imbalanced immune response, hypercoagulation and hyperperfusion, pre-existing conditions or multiorgan failure [ 61 , 63 , 64 , 65 , 66 , 67 , 68 , 69 ]. In addition, COVID-19 vaccine safety reviews had low rates of CMR and EMB confirmation [ 17 , 84 , 85 , 86 , 87 ], causing difficulties to determine whether these reactions meet myocarditis criteria.…”

A Composite Ranking of Risk Factors for COVID-19 Time-To-Event Data from a Turkish Cohort

“…Low calcium level is associated with poor prognosis of COVID-19 (Di Filippo et al, 2020; Liu et al, 2020; Lee et al, 2022), probably due to its role in viral infection and replication.…”