Extent of lung involvement over severity of cardiac disease for the prediction of adverse outcome in COVID-19 patients with cardiovascular disease

Int J Cardiol. 2021 Jan 15:323:292-294. doi: 10.1016/j.ijcard.2020.10.006. Epub 2020 Oct 8.

Abstract

Background: Aim of the present study was to assess if the presence of high cardiovascular risk, left ventricle systolic dysfunction or elevated BNP or Troponin are able to independently predict the outcome of patients with known cardiac disease and COVID-19 pneumonia.

Methods and results: From March 7th to April 28th, forty consecutive patients with known cardiac disease (chronic coronary artery disease, n=38; atrial fibrillation, n = 7; valvular disease, n = 13) referred to our emergency department for symptoms of suspected COVID-19, laboratory diagnosis of COVID-19 and typical signs of viral pneumonia at chest CT were enrolled in the study. The only predictor of the composite end-point (all cause of death + invasive ventilation + thromboembolic event) was the lung involvement % at chest CT (OR: 1.06; 95%CI: 1.01-1.11, P = 0.02). In the multivariate analysis, the lung involvement % at chest CT was the only independent predictor of the composite end-point (OR: 1.06; 95%CI: 1.01-1.11, P = 0.034).

Conclusions: The extent of lung involvement by COVID-19 is the only independent predictor of adverse outcome of patients and is predominant over the severity of cardiac disease.

Keywords: Covid-19; cardiovascular disease; lung disease; non-contrast CT scan.

MeSH terms

  • Aged
  • COVID-19 / complications*
  • COVID-19 / mortality
  • Cardiovascular Diseases / complications*
  • Emergency Service, Hospital
  • Female
  • Hospitalization
  • Humans
  • Italy / epidemiology
  • Lung / diagnostic imaging*
  • Male
  • Multivariate Analysis
  • Respiration, Artificial / statistics & numerical data
  • Severity of Illness Index*
  • Thromboembolism / virology
  • Tomography, X-Ray Computed