CHA2DS2-VASc score and modified CHA2DS2-VASc score can predict mortality and intensive care unit hospitalization in COVID-19 patients

J Thromb Thrombolysis. 2021 Oct;52(3):914-924. doi: 10.1007/s11239-021-02427-1. Epub 2021 Mar 17.

Abstract

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.

Keywords: CHA2DS2-VASc score; COVID-19; Intensive care unit hospitalization; Modified CHA2DS2-VASc score; Mortality.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Biomarkers / blood
  • COVID-19 / blood
  • COVID-19 / diagnosis*
  • COVID-19 / mortality
  • COVID-19 / therapy
  • Decision Support Techniques*
  • Female
  • Fibrin Fibrinogen Degradation Products / analysis
  • Hospital Mortality*
  • Hospitalization*
  • Humans
  • Intensive Care Units*
  • Length of Stay
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prognosis
  • Receptors, Immunologic / analysis
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Thromboembolism / blood
  • Thromboembolism / diagnosis*
  • Thromboembolism / mortality
  • Thromboembolism / therapy
  • Time Factors
  • Troponin I / blood
  • Turkey
  • Young Adult

Substances

  • Biomarkers
  • CRP protein, human
  • Fibrin Fibrinogen Degradation Products
  • Receptors, Immunologic
  • Troponin I
  • fibrin fragment D