Department of Medicine, Section of Internal Medicine, University of Verona, Verona, Italy.
Unit of Internal Medicine "Guido Baccelli", Department of Biomedical Sciences and Human Oncology University of Bari, Aldo Moro Medical School, Bari, Italy.
Curr Probl Cardiol. 2021 May;46(5):100819. doi: 10.1016/j.cpcardiol.2021.100819. Epub 2021 Feb 15.
the current understanding of the interplay between cardiovascular (CV) risk and Covid-19 is grossly inadequate. CV risk-prediction models are used to identify and treat high risk populations and to communicate risk effectively. These tools are unexplored in Covid-19. The main objective is to evaluate the association between CV scoring systems and chest X ray (CXR) examination (in terms of severity of lung involvement) in 50 Italian Covid-19 patients. Results only the Framingham Risk Score (FRS) was applicable to all patients. The Atherosclerotic Cardiovascular Disease Score (ASCVD) was applicable to half. 62% of patients were classified as high risk according to FRS and 41% according to ASCVD. Patients who died had all a higher FRS compared to survivors. They were all hypertensive. FRS≥30 patients had a 9.7 higher probability of dying compared to patients with a lower FRS. We found a strong correlation between CXR severity and FRS and ASCVD (P < 0.001). High CV risk patients had consolidations more frequently. CXR severity was significantly associated with hypertension and diabetes. 71% of hypertensive patients' CXR and 88% of diabetic patients' CXR had consolidations. Patients with diabetes or hypertension had 8 times greater risk of having consolidations.
High CV risk correlates with more severe CXR pattern and death. Diabetes and hypertension are associated with more severe CXR. FRS offers more predictive utility and fits best to our cohort. These findings may have implications for clinical practice and for the identification of high-risk groups to be targeted for the vaccine precedence.
目前对心血管（CV）风险与 COVID-19 之间相互作用的理解非常不足。CV 风险预测模型用于识别和治疗高危人群，并有效地传达风险。这些工具在 COVID-19 中尚未得到探索。主要目的是评估 50 例意大利 COVID-19 患者的 CV 评分系统与胸部 X 光（CXR）检查（在肺部受累严重程度方面）之间的相关性。结果只有 Framingham 风险评分（FRS）适用于所有患者。动脉粥样硬化性心血管疾病评分（ASCVD）适用于一半患者。根据 FRS，62%的患者被归类为高危，根据 ASCVD，41%的患者被归类为高危。死亡患者的 FRS 均高于幸存者。他们都是高血压患者。FRS≥30 的患者死亡的可能性比 FRS 较低的患者高 9.7 倍。我们发现 CXR 严重程度与 FRS 和 ASCVD 之间存在很强的相关性（P<0.001）。高 CV 风险患者更频繁地出现实变。CXR 严重程度与高血压和糖尿病显著相关。71%的高血压患者和 88%的糖尿病患者的 CXR 有实变。患有糖尿病或高血压的患者出现实变的风险增加 8 倍。
高 CV 风险与更严重的 CXR 模式和死亡相关。糖尿病和高血压与更严重的 CXR 相关。FRS 提供了更多的预测效用，最适合我们的队列。这些发现可能对临床实践和确定高危人群以优先接种疫苗具有重要意义。
