Prognosis models for severe and critical COVID-19 based on the Charlson and Elixhauser comorbidity indices

Wei, Zhou; Qin, Xiaoyi; Hu, Xiang; Lu, Yingru; Pan, Jingye

doi:10.7150/ijms.50007

Cited by 29 publications

(30 citation statements)

References 23 publications

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“…These results were similar to previously published data from Denmark (26). Our results indicated that the Charlson comorbidity index is a valid indicator for COVID-19 patients with poor outcomes, in concordance with previous studies (27,28).…”

Section: Discussionsupporting

confidence: 93%

Clinical and Laboratory Findings of COVID-19 in High-Altitude Inhabitants of Saudi Arabia

et al. 2021

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Background: SARS-CoV-2, the causative agent of COVID-19, continues to cause a worldwide pandemic, with more than 147 million being affected globally as of this writing. People's responses to COVID-19 range from asymptomatic to severe, and the disease is sometimes fatal. Its severity is affected by different factors and comorbidities of the infected patients. Living at a high altitude could be another factor that affects the severity of the disease in infected patients.Methods: In the present study, we have analyzed the clinical, laboratory, and radiological findings of COVID-19-infected patients in Taif, a high-altitude region of Saudi Arabia. In addition, we compared matched diseased subjects to those living at sea level. We hypothesized that people living in high-altitude locations are prone to develop a more severe form of COVID-19 than those living at sea level.Results: Age and a high Charlson comorbidity score were associated with increased numbers of intensive care unit (ICU) admissions and mortality among COVID-19 patients. These ICU admissions and fatalities were found mainly in patients with comorbidities. Rates of leukocytosis, neutrophilia, higher D-dimer, ferritin, and highly sensitive C-reactive protein (CRP) were significantly higher in ICU patients. CRP was the most independent of the laboratory biomarkers found to be potential predictors of death. COVID-19 patients who live at higher altitude developed a less severe form of the disease and had a lower mortality rate, in comparison to matched subjects living at sea level.Conclusion: CRP and Charlson comorbidity scores can be considered predictive of disease severity. People living at higher altitudes developed less severe forms of COVID-19 disease than those living at sea level, due to a not-yet-known mechanism.

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Section: Discussionsupporting

confidence: 93%

Clinical and Laboratory Findings of COVID-19 in High-Altitude Inhabitants of Saudi Arabia

et al. 2021

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“…Prior studies using the Charlson 25 and Elixhauser comorbidity indices to account for comorbid conditions in the context of COVID-19 have (1) failed to account for racial disparities 26 , (2) used data from single sites or single hospital systems 19 , 27 – 29 or (3) failed to capture other relevant COVID-19 health outcomes beyond death and hospitalization (e.g., length of hospital stay 30 [LOS], need for ventilation 31 , 32 ). Our study therefore aimed to evaluate 4 COVID-19 health outcomes stratified by ECI ranking: hospitalizations exceeding 24 h, maximum LOS, ventilation, and death.…”

Section: Introductionmentioning

confidence: 99%

Racial disparities in COVID-19 outcomes exist despite comparable Elixhauser comorbidity indices between Blacks, Hispanics, Native Americans, and Whites

Qeadan

VanSant-Webb

Tingey

et al. 2021

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Factors contributing to racial inequities in outcomes from coronavirus disease 2019 (COVID-19) remain poorly understood. We compared by race the risk of 4 COVID-19 health outcomes––maximum length of hospital stay (LOS), invasive ventilation, hospitalization exceeding 24 h, and death––stratified by Elixhauser comorbidity index (ECI) ranking. Outcomes and ECI scores were constructed from retrospective data obtained from the Cerner COVID-19 De-Identified Data cohort. We hypothesized that racial disparities in COVID-19 outcomes would exist despite comparable ECI scores among non-Hispanic (NH) Blacks, Hispanics, American Indians/Alaska Natives (AI/ANs), and NH Whites. Compared with NH Whites, NH Blacks had longer hospital LOS, higher rates of ventilator dependence, and a higher mortality rate; AI/ANs, higher odds of hospitalization for ECI = 0 but lower for ECI ≥ 5, longer LOS for ECI = 0, a higher risk of death across all ECI categories except ECI ≥ 5, and higher odds of ventilator dependence; Hispanics, a lower risk of death across all ECI categories except ECI = 0, lower odds of hospitalization, shorter LOS for ECI ≥ 5, and higher odds of ventilator dependence for ECI = 0 but lower for ECI = 1–4. Our findings contest arguments that higher comorbidity levels explain elevated COVID-19 death rates among NH Blacks and AI/ANs compared with Hispanics and NH Whites.

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“…CCI and ECI are both used widely to predict disease severity, prolonged hospitalization, and even in-hospital mortality with different weights on different chronic conditions [30,31]. CCI and ECI have both been reported to accurately predict COV-ID-19 severity [32][33][34]. Therefore, we can use them as the reference to compare the performance accuracy of the study's simplified comorbidity evaluation (i.e., CCC).…”

Section: Discussionmentioning

confidence: 99%

A Simplified Comorbidity Evaluation Predicting Clinical Outcomes Among Patients With Coronavirus Disease 2019

et al. 2021

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Prognosis models for severe and critical COVID-19 based on the Charlson and Elixhauser comorbidity indices

Cited by 29 publications

References 23 publications

Clinical and Laboratory Findings of COVID-19 in High-Altitude Inhabitants of Saudi Arabia

Clinical and Laboratory Findings of COVID-19 in High-Altitude Inhabitants of Saudi Arabia

Racial disparities in COVID-19 outcomes exist despite comparable Elixhauser comorbidity indices between Blacks, Hispanics, Native Americans, and Whites

A Simplified Comorbidity Evaluation Predicting Clinical Outcomes Among Patients With Coronavirus Disease 2019

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