Coronary calcifications as a new prognostic marker in COVID-19 patients: role of CT.

OBJECTIVE: COVID-19 pneumonia, caused by the virus Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), was declared a pandemic by the WHO on 11th March 2020. While Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) represents the diagnostic gold standard of infection, computed tomography (CT) has been shown to have an important role in supporting the diagnosis, quantifying the severity, and assessing the efficacy of treatment and its response. Coronary artery calcification (CAC) is a CT finding that estimates atherosclerosis and can be quantified using the coronary artery calcium score (CACS). The purpose of this study is to demonstrate the correlation between coronary artery calcification and mortality rate in COVID-19 patients. PATIENTS AND METHODS: Three hundred seventeen (317) hospitalized patients with SARS-CoV-2 infection were ruled in this retrospective study. All patients underwent a non-ECG-gated chest CT to evaluate lung parenchymal involvement. In the same cohort, we observed the two main coronary arteries (common trunk, circumflex, anterior interventricular and right coronary heart) using a visual score, so patients were divided into four groups based on Ordinal CAC Score (OCS) levels. RESULTS: The multivariate analysis proved that the OCS value was statistically correlated with the mortality rate (p < 0.001). In fact, in the group of patients with an OCS value of 0, the mortality rate was 10.1% (10/99 patients), in the group with OCS between 1 and 4 was 18.9% (21/111), in the OCS group of patients ranged from 5 to 8 was 30.4% (24/79) and in the OCS group between 9 and 12 was 46.4% (13/28). CONCLUSIONS: We suggest that calcific atheromasia of the coronary arteries in patients with COVID-19 can be considered a prognostic marker of clinical outcome.

Clinical study of gastrointestinal complications associated with clindamycin therapy.

The incidence of and factors associated with diarrhea were evaluated in 1,000 patients receiving clindamycin. Diarrhea occurred in 6.6% of the patients, and of the many parameters evaluated, a significant association with diarrhea was found only for age (higher incidence in patients older than 20 years), sex (higher incidence in females), and route of administration (higher incidence with oral than with parenteral administration). It is of interest that we were unable to find a positive correlation between dose of drug or duration of therapy and diarrhea. Diarrhea began within 48 hr of start of clindamycin therapy in 52.3% of the patients and within five days of therapy in 75.3%. Nineteen patients developed diarrhea after they had stopped receiving the drug. Duration of diarrhea varied considerably, with a mean of 11.4 days and a range of one to 120 days.

Gastrointestinal side effects associated with clinidamycin. 1,000 consecutive patients.

The incidience and parameters associated with diarrhea related to clindamycin usage were studied in a population of both inpatients and outpatients. Diarrhea occurred in 66 (6.6%) of the 1,000 patients. In three of them, substantial morbidity was associated with the diarrhea. Of the multiple parameters that were evaluated, significant association with diarrhea was found only for age (patients over the age of 20 years) (P less than .01) and sex (females) (P less than .005). Interestingly, dose, duration, and route of administration showed no significant relationship to diarrhea (P greater than .05).