Montazeri Mahnaz, Keykhaei Mohammad, Rashedi Sina, Karbalai Saleh Shahrokh, Pazoki Marzieh, Hadadi Azar, Sharifnia Seyyed Hamidreza, Sotoodehnia Mehran, Ajloo Sanaz, Kafan Samira, Ashraf Haleh
Department of Infectious Diseases, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Research Development Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
J Cardiovasc Thorac Res. 2022;14(1):23-33. doi: 10.34172/jcvtr.2022.07. Epub 2022 Mar 14.
Owing to the imposed burden of the coronavirus disease 2019 (COVID-19),the need for stratifying the prognosis of patients has never been timelier. Hence, we aimed to ascertain the value of CHADS, CHADS-VASc, and CHADS-VASc-M (one point for male instead of female) scores to predict unfavorable outcomes in COVID-19 patients. We enrolled consecutive patients above 18 years of age with confirmed COVID-19,who were admitted between February 16 and November 1, 2020. The primary endpoint of this study was three-month all-cause mortality. The secondary endpoints were considered four major in-hospital clinical features, including acute respiratory distress syndrome, cardiac injury,acute kidney injury, and mechanical ventilation. A total of 1,406 hospitalized COVID-19 patients were studied, among which 301(21.40%) patients died during the follow-up period. Regarding the risk scores, CHADS ≥1,CHADS-VASc≥2, and CHADS-VASc-M≥2 were significantly associated with mortality. The performance of all risk scores for predicting mortality was satisfactory (area under the curve:0.668, 0.668, and 0.681, respectively). Appraising secondary endpoints, we found that all three risk scores were associated with increased risk of acute respiratory distress syndrome, cardiac injury, acute kidney injury, and mechanical ventilation. Lastly, we revealed that all risk scores were significantly correlated with serum levels of laboratory biomarkers. Our analysis illustrated that the CHADS, CHA2DS-VASc, and CHADS-VASc-Mscores could aid prognostication of unfavorable outcomes in COVID-19 patients. Therefore,these easily calculable methods could be integrated into the overall therapeutic strategy to guide the COVID-19 management more accurately.
由于2019冠状病毒病（COVID-19）带来的负担，对患者预后进行分层的需求从未像现在这样迫切。因此，我们旨在确定CHADS、CHADS-VASc和CHADS-VASc-M（男性计1分而非女性）评分对预测COVID-19患者不良结局的价值。我们纳入了2020年2月16日至11月1日期间收治的18岁以上确诊COVID-19的连续患者。本研究的主要终点是三个月全因死亡率。次要终点被认为是四个主要的住院临床特征，包括急性呼吸窘迫综合征、心脏损伤、急性肾损伤和机械通气。共研究了1406例住院COVID-19患者，其中301例（21.40%）患者在随访期间死亡。关于风险评分，CHADS≥1、CHADS-VASc≥2和CHADS-VASc-M≥2与死亡率显著相关。所有风险评分预测死亡率的表现都令人满意（曲线下面积分别为：0.668、0.668和0.681）。评估次要终点时，我们发现所有三个风险评分都与急性呼吸窘迫综合征、心脏损伤、急性肾损伤和机械通气风险增加相关。最后，我们发现所有风险评分都与实验室生物标志物的血清水平显著相关。我们的分析表明，CHADS、CHA2DS-VASc和CHADS-VASc-M评分有助于预测COVID-19患者的不良结局。因此，这些易于计算的方法可以纳入整体治疗策略，以更准确地指导COVID-19的管理。
