Systematic review and meta-analysis on coronary calcifications in COVID-19

Emerg Radiol. 2022 Aug;29(4):631-643. doi: 10.1007/s10140-022-02048-y. Epub 2022 Apr 30.

Abstract

Chest CT is valuable to detect alternative diagnoses/complications of COVID-19, while its role for prognostication requires further investigation. Non-pulmonary radiological findings such as cardiovascular calcifications could increase the predictivity of clinical outcomes of COVID-19 patients beyond pulmonary involvement. Several observational studies have reported mixed results on the role of coronary calcifications in COVID-19 patients as a predictor of hospitalization, ventilatory support, and mortality. The purpose of the study is to systematically review the available evidence on the predictive role of cardiovascular calcifications in SARS-CoV2 disease. The meta-analysis confirms the prognostic significance of coronary calcifications on hospital mortality, and coronary calcifications (CAC ≠ 0) were associated with an OR for mortality of 2.19 (95% CI 1.36-3.52). CAC was neutral on respiratory outcomes, but it was associated with an increased trend of cardiovascular events. Coronary calcium appears as a promising biomarker imaging even in short-term outcomes (MACEs, hospital mortality) in a non-cardiovascular disease such as Sars-CoV2 infection. Further large studies are needed to confirm promising results of this imaging biomarker in non-cardiovascular disease.

Keywords: Biomarker imaging; CAC; CAC-DRS; CACS; COVID-19; Cardiovascular calcifications; Coronary calcifications.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • COVID-19*
  • Calcinosis* / diagnostic imaging
  • Coronary Angiography
  • Coronary Artery Disease*
  • Coronary Vessels
  • Humans
  • RNA, Viral
  • Risk Assessment
  • Risk Factors
  • SARS-CoV-2

Substances

  • RNA, Viral