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Prognostic value of CT-defined coronary sclerosis in COVID-19: Results of a multicenter study based on the Weston score

Bucher AM, Frodl E, Ehrengut C, Müller L, Emrich T, Kloeckner R, Sieren M, Sähn MJ, Fink MA, Móré D, Melekh B, Gottschling S, Meinel F, Schön H, Kornemann N, Renz DM, Lubina N, Wollny C, May M, Siegler L, Borggrefe J, Meyer HJ, Surov A (2025)

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Publication Type: Journal article

Publication year: 2025

Journal

DOI: 10.1055/a-2583-0235

Abstract

Aims Coronary calcification, as defined by computed tomography (CT), can be quantified with a score (CAC score). It is an established prognostic and predictive imaging marker of the cardiovascular risk profile. The prognostic relevance of the CAC score has been demonstrated for acute diseases, including the coronavirus disease 2019 (COVID-19) in preliminary studies. The aim of the present study was to prove the prognostic relevance of the CAC score in patients with coronavirus disease 2019. Materials and Methods The present study used a nationwide radiological research platform to conduct a multicenter retrospective study. The study included a total of 541 patients, 176 of whom were female (32.5%). The mean age of the patients was 61.2 years ± 15.6 years. The coronavirus (SARS-COV-2) disease was confirmed in all patients by PCR testing. The CAC score was calculated using the Weston score, which is a semiquantitative method. The primary outcome of the study was 30-day mortality. Results The overall mortality rate within the 30-day period was 21.2%, with 115 patients dying. The mean Weston score was 3.0 ± 3.6. 128 patients (23.7%) exhibited no evidence of coronary calcifications, as indicated by a Weston Score of 0. In the univariable regression analysis, the presence of calcifications was found to be associated with mortality, with an odds ratio of 1.68 (95% confidence interval 1.08-2.59, p=0.01). However, this result did not remain statistically significant in the multivariable analysis (p=0.49). The Weston score was found to be associated with mortality in the univariable analysis, with an odds ratio (OR) of 1.10 (95% CI 1.04-1.14, p < 0.001), and in the multivariable analysis, with an OR of 1.06 (95% CI 1.005-1.138, p = 0.036). Conclusion The imaging marker CAC score has been demonstrated to have a significant prognostic impact on 30-day mortality in patients diagnosed with coronavirus disease 2019 (COVID-19). It is incumbent upon the radiologist to acknowledge the sole presence of coronary calcifications as a relevant prognostic factor. The prognostic relevance of the calcifications was found to be greater in cases where more extensive calcification was present.

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APA:

Bucher, A.M., Frodl, E., Ehrengut, C., Müller, L., Emrich, T., Kloeckner, R.,... Surov, A. (2025). Prognostic value of CT-defined coronary sclerosis in COVID-19: Results of a multicenter study based on the Weston score. Röfo: Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren. https://doi.org/10.1055/a-2583-0235

MLA:

Bucher, Andreas Michael, et al. "Prognostic value of CT-defined coronary sclerosis in COVID-19: Results of a multicenter study based on the Weston score." Röfo: Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren (2025).

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