Coronary Calcifications are a More Relevant Prognostic Factor for Lethality in Patients with COVID-19

Background: The objective is to evaluate the prognostic factor of lethality of coronary calcifications by the scoring method of overall visual assessment in patients with COVID-19 who underwent chest computed tomography and also evaluate other clinical comorbidities. Methods: This is a retrospective study that evaluated coronary calcifications scoring by qualitative overall visual inspection of 201 patients with COVID-19 who required Chest computed tomography to evaluate lung complications. The coronary calcifications scoring was analyzed by qualitative evaluation of chest computed tomography scans by radiologists who gave a rating on a scale of 0 to 4 (0= no coronary calcifications CACs; 1= discrete coronary calcifications; 2= moderate coronary calcifications; 3= marked coronary calcifications; 4=stent). Results: The average age of patients who died from COVID-19 was 59 years (SD = 19) with a significant difference for those who did not die (47.3 years (SD 11.9). The lethality of the sample was 9. 0%, being 35.3% in the group with coronary calcifications (scale of 2; 3 and 4) , while in the group without coronary calcifications (scale of 0 and 1) it was 6.5% (p= 0.001). It is observed that patients with comorbidities have a statistically significant association with the outcome of death when compared to groups without these comorbidities: systemic arterial hypertension (18.3% vs 5.9% p= 0.009), diabetes mellitus (29% vs 6. 2% p= 0.001), dyspnea (15.2% vs 4.7% p=0.025) and chronic renal failure (28% vs 7.2% p=0.06). In the multivariate analysis, coronary calcifications stood out as the main risk factor for the death of patients with COVID-19 (p = 0.030; OR 5.13) followed by diabetes mellitus (p = 0.010; OR 4.71) and chronic kidney failure (p = 0.029; OR 3.98). Conclusion: Moderate, severe coronary calcifications and stent are the more relevant prognostic factor, being a major risk factor for lethality in patients with COVID-19 in our study.