The Usefulness of the C2HEST Risk Score in Predicting Clinical Outcomes among Hospitalized Subjects with COVID-19 and Coronary Artery Disease

• Published in: Viruses 2022-08, Vol.14 (8), p.1771
• Main Authors: Rola, Piotr, Doroszko, Adrian, Trocha, Małgorzata, Gajecki, Damian, Gawryś, Jakub, Matys, Tomasz, Giniewicz, Katarzyna, Kujawa, Krzysztof, Skarupski, Marek, Adamik, Barbara, Kaliszewski, Krzysztof, Kiliś-Pstrusińska, Katarzyna, Matera-Witkiewicz, Agnieszka, Pomorski, Michał, Protasiewicz, Marcin, Madziarski, Marcin, Madej, Marta, Gogolewski, Grzegorz, Chourasia, Goutam, Zielińska, Dorota, Włodarczak, Szymon, Rabczyński, Maciej, Sokołowski, Janusz, Jankowska, Ewa Anita, Madziarska, Katarzyna
• Format: Article
• Language: English
• Subjects: C2HEST score; Chronic obstructive pulmonary disease; Congestive heart failure; Coronary artery; coronary artery disease; Coronaviruses; COVID-19; Heart diseases; Liver diseases; Mortality; Patients; Pneumonia; Renal function; risk assessment; Risk factors; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Vein & artery diseases
• ISSN: 1999-4915; 1999-4915
• DOI: 10.3390/v14081771

Background: Even though coronary artery disease (CAD) is considered an independent risk factor of an unfavorable outcome of SARS-CoV-2-infection, the clinical course of COVID-19 in subjects with CAD is heterogeneous, ranging from clinically asymptomatic to fatal cases. Since the individual C2HEST components are similar to the COVID-19 risk factors, we evaluated its predictive value in CAD subjects. Materials and Methods: In total, 2183 patients hospitalized due to confirmed COVID-19 were enrolled onto this study consecutively. Based on past medical history, subjects were assigned to one of two of the study arms (CAD vs. non-CAD) and allocated to different risk strata, based on the C2HEST score. Results: The CAD cohort included 228 subjects, while the non-CAD cohort consisted of 1956 patients. In-hospital, 3-month and 6-month mortality was highest in the high-risk C2HEST stratum in the CAD cohort, reaching 43.06%, 56.25% and 65.89%, respectively, whereas in the non-CAD cohort in the high-risk stratum, it reached: 26.92%, 50.77% and 64.55%. Significant differences in mortality between the C2HEST stratum in the CAD arm were observed in post hoc analysis only for medium- vs. high-risk strata. The C2HEST score in the CAD cohort could predict hypovolemic shock, pneumonia and acute heart failure during hospitalization, whereas in the non-CAD cohort, it could predict cardiovascular events (myocardial injury, acute heart failure, myocardial infract, carcinogenic shock), pneumonia, acute liver dysfunction and renal injury as well as bleedings. Conclusions: The C2HEST score is a simple, easy-to-apply tool which might be useful in risk stratification, preferably in non-CAD subjects admitted to hospital due to COVID-19.