Quisi Alaa, Alıcı Gökhan, Harbalıoğlu Hazar, Genç Ömer, Er Fahri, Allahverdiyev Samir, Yıldırım Abdullah, Kurt Ibrahim Halil
Department of Cardiology, Medline Hospital Adana, Adana, Turkey.
Department of Cardiology, Okmeydanı Training and Research Hospital, İstanbul, Turkey.
Turk Kardiyol Dern Ars. 2020 Oct;48(7):656-663. doi: 10.5543/tkda.2020.03488.
Coronavirus disease 2019 (COVID-19) is an infectious disease that was first reported in December 2019 in Wuhan, China, and has since spread rapidly around the world, resulting in the ongoing COVID-19 pandemic. The CHA2DS2-VASc score is a well-validated risk stratification tool for predicting stroke in atrial fibrillation (AFib), as well as morbidity and mortality in several entities. The aim of this study was to evaluate the relationship between the CHA2DS2-VASc score and in-hospital mortality in patients with COVID-19, regardless of AFib.
This multicenter, retrospective study included a total of 349 patients with COVID-19 who were hospitalized between March 15 and April 15, 2020. The CHA2DS2-VASc score of each patient was calculated. Mortality outcomes were followed up until April 25, 2020.
The CHA2DS2-VASc score was significantly higher in non-survivor COVID-19 patients than in survivor COVID-19 patients (p<0.001). Forward stepwise logistic regression analysis demonstrated that a CHA2DS2-VASc score of ≥3 (odds ratio [OR]: 12.613, 95% confidence interval [CI]: 3.092-51.451; p<0.001), and the leukocyte count (OR: 1.327, 95% CI: 1.145-1.538; p<0.001), C-reactive protein level (OR: 1.010, 95% CI: 1.002-1.018; p=0.012), and ferritin level (OR: 1.005, 95% CI: 1.003-1.007; p<0.001) on admission were independent predictors of in-hospital mortality of COVID-19 patients.
The CHA2DS2-VASc score predicted in-hospital mortality in patients with COVID-19, regardless of AFib.
2019冠状病毒病（COVID-19）是一种传染病，于2019年12月在中国武汉首次报告，此后在全球迅速传播，导致了持续的COVID-19大流行。CHA2DS2-VASc评分是一种经过充分验证的风险分层工具，用于预测心房颤动（AFib）患者的中风以及多个实体的发病率和死亡率。本研究的目的是评估CHA2DS2-VASc评分与COVID-19患者（无论是否患有AFib）住院死亡率之间的关系。
这项多中心回顾性研究共纳入了2020年3月15日至4月15日期间住院的349例COVID-19患者。计算了每位患者的CHA2DS2-VASc评分。对死亡率结局进行随访至2020年4月25日。
COVID-19非存活患者的CHA2DS2-VASc评分显著高于存活患者（p<0.001）。向前逐步逻辑回归分析表明，CHA2DS2-VASc评分≥3（比值比[OR]：12.613，95%置信区间[CI]：3.092-51.451；p<0.001），以及入院时的白细胞计数（OR：1.327，95%CI：1.145-1.538；p<0.001）、C反应蛋白水平（OR：1.010，95%CI：1.002-1.018；p=0.012）和铁蛋白水平（OR：1.005，95%CI：1.003-1.007；p<0.001）是COVID-19患者住院死亡率的独立预测因素。
无论是否患有AFib，CHA2DS2-VASc评分均可预测COVID-19患者的住院死亡率。
