Charlson comorbidity index and a composite of poor outcomes in COVID-19 patients: A systematic review and meta-analysis

Abstract

Background and aims The ongoing COVID-19 pandemic is disproportionately affecting patients with comorbidities. Therefore, thorough comorbidities assessment can help establish risk stratification of patients with COVID-19, upon hospital admission. Charlson Comorbidity Index (CCI) is a validated, simple, and readily applicable method of estimating the risk of death from comorbid disease and has been widely used as a predictor of long-term prognosis and survival. Methods We performed a systematic review and meta-analysis of CCI score and a composite of poor outcomes through several databases. Results Compared to a CCI score of 0, a CCI score of 1–2 and CCI score of ≥3 was prognostically associated with mortality and associated with a composite of poor outcomes. Per point increase of CCI score also increased mortality risk by 16%. Moreover, a higher mean CCI score also significantly associated with mortality and disease severity. Conclusion CCI score should be utilized for risk stratifications of hospitalized COVID-19 patients.

Liver function test abnormalities at hospital admission are associated with severe course of SARS-CoV-2 infection: a prospective cohort study

“…The combination of hypoalbuminaemia and TBIL elevation at admission on the other hand was associated with a nearly 10-fold risk increase for COVID-19-related death. Furthermore, we performed logistic regression adjusting for gender and the Charlson Comorbidity Index, which is used for the risk stratification of hospitalised COVID-19 patients, 15 and similar results were obtained ( online supplemental table 4 ). Any liver biochemistry abnormality, elevation of AST, ALT and GGT as well as hypoalbuminaemia remained strongly associated with ICU admission, while liver biochemistry abnormality of any kind, AST elevation and hypoalbuminaemia were independent risk factors for the composite endpoint of severe COVID-19.…”

High dimensional profiling identifies specific immune types along the recovery trajectories of critically ill COVID19 patients

“…2 h, r = − 0.4, p = 0.02). In addition, Charlson comorbidity indices [ 35 ] were low for all patients (Table 1 ), indicating that the majority of patients admitted to ICU were in good general health before their infection with SARS-CoV-2. We also did not observe correlations of the Charlson comorbidity indices to either the NLRs or the required level of respiratory support (not shown).…”

Clinical frailty scale and mortality in COVID-19: A systematic review and dose-response meta-analysis

“…Not only is it oversimplifying a multifaceted matter, this one-dimensional approach is inconsistent with the core concept of geriatric medicine. At the very least, multi-comorbidities should as well be taken into account because it is undeniably contributed to the poor outcome among these elderly patients, as we have previously shown that per point increase in Charlson comorbidity index (CCI), could increase the mortality rate by 16% ( Tuty Kuswardhani et al., 2020 ).…”