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Risk Stratification Models for Stroke in Patients Hospitalized with COVID-19 Infection
Alexander E Merkler1, Cenai Zhang1, Ivan Diaz2
1Clinical and Translational Neuroscience Unit, Department of Neurology and Feil Brain and Mind Research Institute, Weill Cornell Medicine, New York, United States.
Summary
A new COVID-19 stroke risk score, CANDLE, helps identify high-risk patients. This practical tool aids clinicians in stratifying stroke risk for hospitalized COVID-19 patients.
Area of Science:
- Cardiovascular Medicine
- Infectious Diseases
- Neurology
Background:
- Hospitalized COVID-19 patients face increased risk of cerebrovascular events.
- Accurate risk stratification is crucial for timely intervention.
Purpose of the Study:
- To develop and validate predictive models for stroke risk in COVID-19 patients.
- To create a practical clinical score for risk stratification.
Main Methods:
- Utilized data from the AHA's Get With The Guidelines® COVID-19 Cardiovascular Disease Registry (122 centers, March 2020-March 2021).
- Employed Cox regression and machine learning techniques to identify stroke risk factors.
- Developed the COVID-19 Acute Neurological Disease and Long-term Events (CANDLE) score.
Main Results:
- Among 21,420 patients, 1.5% experienced a cerebrovascular event.
- The CANDLE score demonstrated a C-statistic of 0.66 for predicting stroke risk.
- CANDLE effectively stratified patients into low (0.2%), medium (1.1%), and high (2.1-3.0%) risk groups.
Conclusions:
- A practical clinical score (CANDLE) was developed to stratify stroke risk in COVID-19 patients.
- The CANDLE score performs comparably to machine learning estimators.
- This score can aid clinicians in managing stroke risk in hospitalized COVID-19 patients.
