Abstract

Objective:

Myocardial injury incidence is high in critically ill patients with coronavirus disease-2019 (COVID-19) and mortality increases in COVID-19 patients with myocardial injury. Our objective was to determine the association between chest computed tomography (CT)-based measurements and myocardial injury in critically ill patients with COVID-19.

Materials and Methods:

We conducted a single-center cohort study of patients admitted to the intensive care unit (ICU) with a diagnosis of COVID-19 who underwent chest CT. Myocardial injury was defined as high-sensitivity troponin I blood levels above the 99th percentile upper reference limit, independent of new abnormalities in electrocardiography and echocardiography. Demographic, clinical, laboratory results, and chest CT findings were collected at ICU admission.

Results:

A total of 213 patients were included. Of the 213 patients, 69 (32.4%) were female, and 144 (67.6%) were male. Myocardial injury incidence was 61.0% (n=130). Acute Physiology and Chronic Health Evaluation-II score [odds ratio (OR): 1.07, 95% confidence interval (CI): 1.02-1.12, p=0.005], having a chest CT severity score ≥18 (OR: 2.85, 95% CI: 1.29-6.32, p=0.010), having any coronary artery calcification (CAC) (OR: 2.45, 95% CI: 1.09-5.52, p=0.030), and age (OR: 1.04, 95% CI: 1.01-1.08, p=0.041), as factors independently associated with an increased risk of myocardial injury.

Conclusion:

The incidence of myocardial injury is high in critically ill COVID-19 patients. Chest CT severity score ≥18 and presence of CAC are practical and valuable tools readily available from existing chest CT to predict myocardial injury in critically ill patients with COVID-19.

Keywords: Chest CT severity score, coronary artery calcification, critical care, intensive care unit, myocardial injury, SARS-CoV-2

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Copyright and license

Copyright © 2023 The Author(s). This is an open access article distributed under the Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to cite?

1.
Ergün B, Gezer NS, Küçük M, Yakar MN, Öztürk MC, Demir M, et al. The Association of Chest CT-based Measurements with Myocardial Injury in Critically Ill Patients with COVID-19. Turk J Intensive Care. 2023;21(2):83-92. https://doi.org/10.4274/tybd.galenos.2022.35119