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Usefulness of the CHA2DS2-VASc Score in Predicting the Outcome in Subjects Hospitalized with COVID-19-A Subanalysis
Katarzyna Resler1, Pawel Lubieniecki2, Tomasz Zatonski1
1Clinical Department of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland.
Insights
The CHA₂DS₂-VASc score, typically used for stroke risk, can predict COVID-19 severity and outcomes. This score helps identify patients at higher risk for complications and mortality during hospitalization.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- COVID-19 poses significant risks to hospitalized patients.
- Predictive tools are crucial for managing COVID-19 severity.
- The CHA₂DS₂-VASc score is a validated tool for cardiovascular risk stratification.
Purpose of the Study:
- To evaluate the clinical relevance of the CHA₂DS₂-VASc score in predicting COVID-19 patient outcomes.
- To assess the score's ability to predict hospitalization duration, ICU admission, and mortality.
- To explore the score's utility in stratifying risk for adverse events in COVID-19.
Main Methods:
- Retrospective analysis of 2183 COVID-19 patients.
- Application of the CHA₂DS₂-VASc score to all hospitalized patients.
- Observation from admission to discharge or death, with prospective follow-up for 90 and 180 days.
Main Results:
- Lower CHA₂DS₂-VASc scores correlated with shorter hospitalization times.
- The score predicted various adverse events including cardiogenic events, stroke/TIA, acute heart failure, pneumonia, and acute renal failure.
- Gender did not significantly impact mortality rates in this cohort.
Conclusions:
- The CHA₂DS₂-VASc score demonstrates clinical utility in predicting COVID-19 severity and patient outcomes.
- Its application may extend beyond thromboembolic risk assessment in COVID-19 patients.
- Routine use could aid in risk stratification and management of COVID-19.
Background:
The aim of this study was to see if the CHA2DS2-VASc score (Cardiac failure or dysfunction, Hypertension, Age ≥ 75 [Doubled], Diabetes, Stroke [Doubled]-Vascular disease, Age 65-74 and Sex category [Female] score) could have potential clinical relevance in predicting the outcome of hospitalization time, need for ICU hospitalization, survival time, in-hospital mortality, and mortality at 3 and 6 months after discharge home.
Materials:
A retrospective analysis of 2183 patients with COVID-19 hospitalized at the COVID-19 Centre of the University Hospital in Wrocław, Poland, between February 2020 and June 2021, was performed. All medical records were collected as part of the COronavirus in LOwer Silesia-the COLOS registry project. The CHA2DS2-VASc score was applied for all subjects, and the patients were observed from admission to hospital until the day of discharge or death. Further information on patient deaths was prospectively collected following the 90 and 180 days after admission. The new risk stratification derived from differences in survival curves and long-term follow-up of our patients was obtained. Primary outcomes measured included in-hospital mortality and 3-month and 6-month all-cause mortality, whereas secondary outcomes included termination of hospitalization from causes other than death (home discharges/transfer to another facility or deterioration/referral to rehabilitation) and non-fatal adverse events during hospitalization.
Results:
It was shown that gender had no effect on mortality. Significantly shorter hospitalization time was observed in the group of patients with low CHA2DS2-VASc scores. Among secondary outcomes, CHA2DS2-VASc score revealed predictive value in both genders for cardiogenic (5.79% vs. 0.69%; p < 0.0001), stroke/TIA (0.48% vs. 9.92%; p < 0.0001), acute heart failure (0.97% vs. 18.18%; p < 0.0001), pneumonia (43% vs. 63.64%; p < 0.0001), and acute renal failure (7.04% vs. 23.97%; p < 0.0001). This study points at the usefulness of the CHA2DS2-VASc score in predicting the severity of the course of COVID-19.
Conclusions:
Routine use of this scale in clinical practice may suggest the legitimacy of extending its application to the assessment of not only the risk of thromboembolic events in the COVID-19 cohort.
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