CHA2DS2-VASc score and modified CHA2DS2-VASc score can predict mortality and intensive care unit hospitalization in COVID-19 patients

Abstract

In this study, we investigated whether the CHA2DS2-VASc score could be used to estimate the need for hospitalization in the intensive care unit (ICU), the length of stay in the ICU, and mortality in patients with COVID-19. Patients admitted to Merkezefendi State Hospital because of COVID-19 diagnosis confirmed by RNA detection of virus by using polymerase chain reaction between March 24, 2020 and July 6, 2020, were screened retrospectively. The CHA2DS2-VASc and modified CHA2DS2-VASc score of all patients was calculated. Also, we received all patients' complete biochemical markers including D-dimer, Troponin I, and c-reactive protein on admission. We enrolled 1000 patients; 791 were admitted to the general medical service and 209 to the ICU; 82 of these 209 patients died. The ROC curves of the CHA2DS2-VASc and M-CHA2DS2-VASc scores were analyzed. The cutoff values of these scores for predicting mortality were ≥ 3 (2 or under and 3). The CHA2DS2-VASc and M-CHA2DS2-VASc scores had an area under the curve value of 0.89 on the ROC. The sensitivity and specificity of the CHA2DS2-VASc scores were 81.7% and 83.8%, respectively; the sensitivity and specificity of the M-CHA2DS2-VASc scores were 85.3% and 84.1%, respectively. Multivariate logistic regression analysis showed that CHA2DS2-VASc, Troponin I, D-Dimer, and CRP were independent predictors of mortality in COVID-19 patients. Using a simple and easily available scoring system, CHA2DS2-VASc and M-CHA2DS2-VASc scores can be assessed in patients diagnosed with COVID-19. These scores can predict mortality and the need for ICU hospitalization in these patients.

Prognostic Accuracy of the Modified CHA2DS2-VASc Score in COVID-19 Patients Admitted to the Emergency Department Due to Clinical Worsening

“…Recently, Gunduz et al also showed the predictive value of the M-CHA2DS2-VASc score for ICU admission. 16 Consistent with these results, we demonstrated that the M-CHA2DS2-VASc score was an independent predictor of mortality in COVID-19 patients (OR: 1.406, 95% IC 1.096 -1.805, p = 0.007). In our cohort, COVID-19 patient non-survivors had significantly higher M-CHA2DS2-VASc [4 (IQR 3 -5) vs 2 (IQR 1 -4), respectively, p < 0.001] compared to survivors.…”

Development of a prediction score for in-hospital mortality in COVID-19 patients with acute kidney injury: a machine learning approach

“…The final model was compared with two available models that have been externally validated in the general population: the CHA2DS2-VASc 19 and the clinical predictive model proposed by Wang et al 20 . The CHA2DS2-VASc is used to estimate thromboembolic stroke risk in atrial fibrillation and thrombotic risk in cardiac diseases and was evaluated in patients diagnosed with COVID-19.…”

CHA2DS2-VASc score on admission to predict mortality in COVID-19 patients: A meta-analysis

“…Studies by Caetinkal 8 et al and Cicek 9 et al were found to have high risk of confounding factors as it was not clearly mentioned how the assessment was done. Study by Gunduz 10 et al was found to have high risk of attrition as control population follow up was not mentioned. Studies by Caro-codon 11 et al and Ruocco 12 et al scored low to moderate in various Risk of Bias domains.…”

“…The positive likelihood ratio was 2.8 (95% CI 2.0-4.0) and the negative likelihood ratio was 0.37 (95% CI 0.26-0.54). The diagnostic odds ratio (DOR) was 8 (95% CI [4][5][6][7][8][9][10][11][12][13][14][15]. The pooled AUC of CHA2DS2-VASc score for discriminating mortality was 0.80 (95% CI 0.76-0.83), indicating that it has high predicting accuracy (Figure 5).…”