Comparison of clinical and radiological characteristics of COVID-19 patients with and without pneumothorax and/or pneumediastinum.

Introduction: Pneumothorax (PTX) and pneumomediastinum (PM) are frequently encountered in patients with Coronavirus disease 2019 (COVID-19) and complicate the management of these patients. In this study, we aimed to evaluate the risk factors that cause PTX/PM complications in patients hospitalized due to COVID-19 pneumonia and the effects of these complications on the course of the disease. Materials and Methods: A total of 503 patients with COVID-19 hospitalized in the COVID-19 ward or intensive care unit (ICU) between September 2020 and December 2020 were included in the study. Result: The median age of patients was 65 (min-max, 21-99) years. Of the patients 299 (59.4%) were male and 204 (40.6%) were female. Of the cases, 26 (5.2%) developed PTX or PM. The patients who developed PTX/PM were older than patients who did not [58.5 (min-max, 21-96) vs 65 years (min-max, 22-99), p= 0.029]. The percentage of PTX/PM development was significantly higher in male patients [F/M= 4/22 (2/7.4%) vs 200/277 (98/92.6%), p= 0.007]. Hypertension as a comorbidity was more commonly seen in the group without PTX/PM (p= 0.007). Ground-glass opacity was the most common tomographic finding in both groups, it was significantly higher in those who did not develop PTX/PM (p<0.001). The length of hospital stay was shorter in patients with PTX/PM (p<0.001), but mortality was higher (p= 0.04). Conclusions: PTX/PM were relatively more common in COVID-19 patients. These complications may negatively affect the prognosis of the disease.

Coronary artery calcium score percentiles: data from a single center in Turkey.

PURPOSE: The coronary artery calcium (CAC) score is used in decision-making for preventive medications in patients with borderline clinical risk scores. Both absolute and percentile CAC scores can be used; however, a percentile CAC score is especially useful in young patients and women. The aim of this study is to present CAC score percentiles across age categories in women and men using a large database. METHODS: Bilkent City Hospital database was screened for patients who underwent CAC score measurements between January 2021 and March 2022. Of the 4,487 patients, 546 were excluded due to 1) a history of coronary stent implantation or bypass surgery or 2) missing information regarding a history of revascularization or calcium scores. Therefore, the final study population included 3,941 participants. The percentiles for age categories within each sex were tabulated, and percentile plots were created for each sex using locally weighted scatterplot smoothing regression. RESULTS: The proportion of men included in the study was higher compared with that of women (57.09% vs. 42.91%). The mean age was 52.20 ± 11.11 years, and it was higher in women than in men (54.07 ± 10.47 vs. 50.80 ± 11.37, respectively; P < 0.001). A zero CAC score was observed in 2,381 (60.42%) patients; the percentage was higher in women than in men (68.60% vs. 54.27%; P < 0.001). When the cut-off value for the high-risk category was taken as the 75th percentile, a non-zero CAC score directly assigned a patient into the high-risk category in women aged <55 years and men aged <45 years. Percentile plots were also provided for each sex. CONCLUSION: In this large-scale study, including patients referred for CAC scoring and/or coronary computed tomography angiography, CAC score percentiles were provided for women and men across the selected age categories which may be in therapeutic decision-making. As an approximate rule of thumb, a non-zero CAC score corresponds to the high-risk category in women aged <55 years and in men aged <45 years.

Time difference for the presence of coronary calcium in those with and without coronary risk factors and statin use.

BACKGROUND: Coronary artery calcium (CAC) is a marker of subclinical atherosclerosis. We aimed to assess to what extent risk factors and statin use modify the time to occurrence of CAC. METHODS: The study population included 3484 patients who underwent CAC score measurements and CT angiography between January 2021 and March 2022. To assess to what extent risk factors and statin use modify the time to occurrence of CAC, a time difference for a 50% probability of having a non-zero CAC score between those with and without these factors was calculated. RESULTS: The mean age was 52.1 ± 10.9 years, and 43.1% of the population were women. Age was the most important factor for having non-zero CAC (z value 21.84, p-value <0.001). This is followed by male gender (Odds ratio [OR] and 95% CI 3.53 [2.96-4.21]; p < 0.001), and statin use (OR 3.09 [2.41-3.97], p < 0.001). A non-zero CAC develops on average 10.3 years earlier in men compared with women, and 9.1 years earlier in statin users compared with non-users. Diabetes mellitus, hypertension, and smoking were also associated with earlier occurrence of CAC score, but to a lower extent. CONCLUSION: Apart from age, male gender and statin use are the major factors for the occurrence of CAC and are associated with CAC occurrence 9-10 years earlier.