Coronary calcium score as a predictor of outcomes in the hypertensive Covid-19 population: results from the Italian (S) Core-Covid-19 Registry

Alberto Cereda, Marco Toselli, Anna Palmisano, Davide Vignale, Arif Khokhar, Gianluca Campo, Matteo Bertini, Marco Loffi, Daniele Andreini, Gianluca Pontone, Gianluigi Patelli, Giuseppe Massimo Sangiorgi, Gabriele Tumminello, Mariarosa Elia, Attilio Iacovoni, Stefano Carugo, Claudio Rapezzi, Antonio Colombo, Francesco Giannini, Antonio Esposito

Research output: Contribution to journalArticlepeer-review


Hypertension is associated with more severe disease and adverse outcomes in COVID-19 patients. Recent investigations have indicated that hypertension might be an independent predictor of outcomes in COVID-19 patients regardless of other cardiovascular and noncardiovascular comorbidities. We explored the significance of coronary calcifications in 694 hypertensive patients in the Score-COVID registry, an Italian multicenter study conducted during the first pandemic wave in the Western world (March-April 2020). A total of 1565 patients admitted with RNA-PCR-positive nasopharyngeal swabs and chest computed tomography (CT) at hospital admission were included in the study. Clinical outcomes and cardiovascular calcifications were analyzed independently by a research core lab. Hypertensive patients had a different risk profile than nonhypertensive patients, with more cardiovascular comorbidities. The deceased hypertensive patients had a greater coronary calcification burden at the level of the anterior descending coronary artery. Hypertension status and the severity cutoffs of coronary calcifications were used to stratify the clinical outcomes. For every 100-mm3 increase in coronary calcium volume, hospital mortality in hypertensive patients increased by 8%, regardless of sex, age, diabetes, creatinine, and lung interstitial involvement. The coronary calcium score contributes to stratifying the risk of complications in COVID-19 patients. Cardiovascular calcifications appear to be a promising imaging marker for providing pathophysiological insight into cardiovascular risk factors and COVID-19 outcomes.

Original languageEnglish
Pages (from-to)333-343
JournalHypertension Research
Issue number2
Publication statusPublished - 2022


  • Calcium Score
  • Cardiovascular Calcification
  • Coronary Calcification
  • Covid-19
  • Hypertension

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine


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