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Prognostic value of GRACE risk score in patients hospitalized for coronavirus disease 2019

Esra Dönmez1, Sevgi Özcan1, Sevil Tuğrul2

  • 1Department of Cardiology, Bağcilar Training and Research Hospital.

Coronary Artery Disease
|July 11, 2022
PubMed

Insights

The Global Registry of Acute Coronary Events (GRACE) risk score effectively predicts mortality and adverse events in hospitalized COVID-19 patients. Higher GRACE scores correlate with increased need for intensive care and major ischemic events.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • The COVID-19 pandemic presents ongoing health threats with emerging variants and varied disease severity.
  • Identifying patients at high risk for intensive care unit (ICU) admission and mortality is crucial.
  • The Global Registry of Acute Coronary Events (GRACE) risk score is established for acute coronary syndrome risk stratification.

Purpose of the Study:

  • To assess the utility of the GRACE risk score in predicting adverse outcomes and major ischemic events in hospitalized COVID-19 patients.
  • To determine if GRACE score can stratify risk for mortality, ICU admission, and advanced ventilatory support.
  • To explore correlations between GRACE score and inflammatory/cardiac biomarkers.

Main Methods:

  • A retrospective study included 787 hospitalized COVID-19 patients.
  • Patients were categorized into low (0-108), intermediate (109-140), and high (≥141) GRACE risk score groups.
  • Inhospital outcomes, ICU needs, and major ischemic events were analyzed in relation to GRACE scores.

Main Results:

  • Increasing GRACE risk scores were significantly associated with higher inhospital mortality, longer hospital stays, and increased need for ICU admission and advanced ventilatory support.
  • Major ischemic events were more frequent in higher GRACE risk score groups.
  • GRACE score showed strong positive correlations with pro-BNP and procalcitonin, and moderate correlations with D-dimer, CRP, and NLR.
  • Multivariate regression identified GRACE risk score as an independent predictor of inhospital mortality, major ischemic events, advanced ventilatory support, and ICU need.

Conclusions:

  • The GRACE risk score is a valuable and easily applicable tool for risk stratification of hospitalized COVID-19 patients upon admission.
  • It aids in identifying patients requiring medium- to high-intensity care and optimizing resource allocation.
  • The GRACE score demonstrates predictive power for adverse outcomes in the context of COVID-19 infection.
Abstract

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