Department of Cardiology, Manisa City Hospital, Manisa, Turkey.
Facultyof Medicine, Department of Cardiology, Manisa Celal Bayar University Manisa, Manisa, Turkey.
J Thromb Thrombolysis. 2021 Oct;52(3):914-924. doi: 10.1007/s11239-021-02427-1. Epub 2021 Mar 17.
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 cut-off 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.
在这项研究中，我们调查了 CHA2DS2-VASc 评分是否可用于估计 COVID-19 患者入住重症监护病房（ICU）的需求、ICU 住院时间和死亡率。回顾性筛选了 2020 年 3 月 24 日至 2020 年 7 月 6 日期间因病毒 RNA 检测确诊为 COVID-19 而入住梅泽菲登迪州立医院的患者。计算了所有患者的 CHA2DS2-VASc 和改良 CHA2DS2-VASc 评分。此外，我们在入院时收到了所有患者的完整生化标志物，包括 D-二聚体、肌钙蛋白 I 和 C-反应蛋白。我们共纳入了 1000 名患者；其中 791 名患者入住普通医疗病房，209 名患者入住 ICU；其中 209 名患者中有 82 名死亡。分析了 CHA2DS2-VASc 和 M-CHA2DS2-VASc 评分的 ROC 曲线。这些评分预测死亡率的截断值为≥3（2 或以下和 3）。CHA2DS2-VASc 和 M-CHA2DS2-VASc 评分的 ROC 曲线下面积分别为 0.89。CHA2DS2-VASc 评分的敏感性和特异性分别为 81.7%和 83.8%；M-CHA2DS2-VASc 评分的敏感性和特异性分别为 85.3%和 84.1%。多变量逻辑回归分析显示，CHA2DS2-VASc、肌钙蛋白 I、D-二聚体和 CRP 是 COVID-19 患者死亡的独立预测因子。使用简单且易于获得的评分系统，可对诊断为 COVID-19 的患者进行 CHA2DS2-VASc 和 M-CHA2DS2-VASc 评分评估。这些评分可预测这些患者的死亡率和入住 ICU 的需求。
