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Cardiovascular Risk Score and Pulmonary Gas Exchange in COVID-19 Patients Show No Correlation
Sebastiano Cicco1,2, C Mozzini3, R Carella1
1COVID Section, Unit of Internal Medicine "Guido Baccelli", Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy.
Insights
Cardiovascular disease (CVD) significantly increases COVID-19 mortality risk. Higher Framingham Risk Scores (FRS) in deceased patients correlated with reduced lung function, not blood gas levels or inflammation.
Area of Science:
- Cardiology
- Infectious Diseases
- Pulmonology
Background:
- COVID-19 is associated with systemic inflammation and increased mortality risk in patients with cardiovascular disease (CVD).
- Identifying predictors of negative outcomes is crucial for clinical management.
- Cardiovascular disease risk scores are valuable tools for assessing cardiovascular event risk.
Purpose of the Study:
- To evaluate oxygenation and patient characteristics in COVID-19 patients stratified by cardiovascular risk using the Framingham Risk Score (FRS).
Main Methods:
- A cohort of 155 COVID-19 patients (110 males, 45 females; mean age 67.43 years) underwent physical examination, chest imaging, laboratory tests, and blood gas analysis.
- Patients were categorized based on their Framingham Risk Score (FRS).
- Outcomes were compared between deceased (17 patients) and surviving (138 patients) groups.
Main Results:
- Deceased patients exhibited significantly higher FRS (27.37 vs. 21.33) and elevated white blood cells and D-dimers compared to survivors.
- No significant differences in pCO2, SO2, or alveolar-arteriolar oxygen difference (A-aDO2) were observed between groups.
- Deceased patients had higher pO2 and lower PaO2/FiO2 (P/F) ratio; FRS negatively correlated with P/F in non-survivors.
Conclusions:
- Cardiovascular disease is a major risk factor for mortality in COVID-19 patients.
- Increased mortality risk is linked to reduced lung capacity, not altered blood gas values.
- Cardiovascular risk scores are independent of the inflammatory status in COVID-19 patients.
Background:
COVID-19 induces robust systemic inflammation. Patients with cardiovascular disease (CVD) are at an increased risk of death. However, much effort is being spent to identify possible predictors of negative outcomes in order to have a more specific clinical setting. CVD scores are a useful tool in evaluating risk of cardiovascular events.
Aim:
We evaluated oxygenation and characteristics in COVID-19 patients according to cardiovascular risk stratification performed using the Framingham risk score (FRS) for cardiovascular disease.
Materials And Methods:
We evaluated 155 COVID-19 patients (110 males and 45 females, aged 67.43 ± 14.72 years). All patients underwent a complete physical examination, chest imaging, laboratory tests and blood gas analysis at the time of diagnosis. Seventeen patients died (10 males and 7 females, aged 74.71 ± 7.23 years) while the remaining 138 patients (100 males and 38 females, aged 66.07 ± 15.16 years) were alive at discharge.
Results:
Deceased patients have an increased FRS compared to those that survived (27.37 ± 5.03 vs. 21.33 ± 9.49, p < 0.05). Compared to survivors, the deceased group presents with a significant increase in white blood cells (p < 0.05) and D-dimers (p < 0.05). There was no difference in pCO2, SO2, and in alveolar arteriolar oxygen difference (A-aDO2). On the contrary, in deceased patients there was an increased pO2 (p < 0.05) and a decreased ratio between oxygen inspired and pO2 (P/F; p < 0.05). FRS shows a negative correlation to P/F (r = 0.42, p < 0.05) in the deceased while no correlation was found in the survivors. No other correlation has been found with blood gas parameters or in the inflammation parameters evaluated in the two groups.
Discussion:
CVD may be considered as a major risk factor for death in COVID-19 patients. The increased risk relates to a reduced lung capacity but it is not related to blood gas values. Similarly, CV risk score results are independent from the inflammatory status of the patients.
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