Mortality prediction using a modified R2CHA2DS2-VASc score among hospitalized COVID-19 patients

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Background: The CHA2DS2-VASc score incorporates comorbidities with prognostic implications in COVID-19. Aim: To assess whether a modified score (M-R2CHA2DS2-VASc), which includes pre-admission kidney function and male sex, could be used to classify mortality risk among people hospitalized with COVID-19. Methods: A retrospective study of adults admitted for COVID-19. Pre-admission glomerular filtration rate (GFR) was calculated based on serum creatinine and used for scoring M-R2CHA2DS2-VASc. Participants were categorized according to the M-R2CHA2DS2-VASc categories as 0-1 (low), 2-3 (intermediate), or ≥4 (high), and according to initial COVID-19 severity. Primary outcome was 30-day mortality rates. Results: Among 800 participants, 55% were males, mean age 65.2±17 years. There were similar proportions of subjects across M-R2CHA2DS2-VASc categories. 30-day mortality was higher in those in higher M-R2CHA2DS2-VASc category and with severe or critical COVID-19 at admission. Mortality rates were 4.7%, 17% and 31% among subjects in the low, intermediate, and high M-R2CHA2DS2-VASc categories, respectively (p<0.001). All-cause 90-day mortality remained significantly associated with M-R2CHA2DS2-VASc. Conclusions: The M-R2CHA2DS2-VASc score is associated with 30-day mortality rates among patients hospitalized with COVID-19, and adds predictive value when combined with initial COVID-19 severity.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.