Mortality Risk Assessment Using CHA(2)DS(2)-VASc Scores in Patients Hospitalized With Coronavirus Disease 2019 Infection

• Published in: The American journal of cardiology 2020-12, Vol.137, p.111-117
• Main Authors: Ruocco, Gaetano, McCullough, Peter A., Tecson, Kristen M., Mancone, Massimo, De Ferrari, Gaetano M., D'Ascenzo, Fabrizio, De Rosa, Francesco G., Paggi, Anita, Forleo, Giovanni, Secco, Gioel G., Pistis, Gianfranco, Monticone, Silvia, Vicenzi, Marco, Rota, Irene, Blasi, Francesco, Pugliese, Francesco, Fedele, Francesco, Palazzuoli, Alberto
• Format: Article
• Language: English
• Subjects: Age; Age Factors; Aged; Aged, 80 and over; Alveoli; Cardiovascular disease; Complications; Coronaviruses; COVID-19; COVID-19 - mortality; COVID-19 - therapy; Death; Diabetes; Diabetes Mellitus - epidemiology; Female; Females; Gender; Health risks; Heart; Heart Failure - epidemiology; Hospital Mortality; Hospitalization; Humans; Hypertension; Hypertension - epidemiology; Infections; Inflammation; Italy - epidemiology; Male; Mechanical ventilation; Middle Aged; Mortality; Myocardial Ischemia - epidemiology; Odds Ratio; Patients; Prognosis; Registries; Respiration, Artificial - statistics & numerical data; Respiratory distress syndrome; Risk Assessment; Severe acute respiratory syndrome coronavirus 2; Sex Factors; Stroke; Stroke - epidemiology; Thromboembolism; Thrombosis; Ventilation; Ventilators; Viral diseases
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2020.09.029

Early risk stratification for complications and death related to Coronavirus disease 2019 (COVID-19) infection is needed. Because many patients with COVID-19 who developed acute respiratory distress syndrome have diffuse alveolar inflammatory damage associated with microvessel thrombosis, we aimed to investigate a common clinical tool, the CHA(2)DS(2)-VASc, to aid in the prognostication of outcomes for COVID-19 patients. We analyzed consecutive patients from the multicenter observational CORACLE registry, which contains data of patients hospitalized for COVID-19 infection in 4 regions of Italy, according to data-driven tertiles of CHA(2)DS(2)-VASc score. The primary outcomes were inpatient death and a composite of inpatient death or invasive ventilation. Of 1045 patients in the registry, 864 (82.7%) had data available to calculate CHA(2)DS(2)-VASc score and were included in the analysis. Of these, 167 (19.3%) died, 123 (14.2%) received invasive ventilation, and 249 (28.8%) had the composite outcome. Stratification by CHA(2)DS(2)-VASc tertiles (T1: ≤1; T2: 2 to 3; T3: ≥4) revealed increases in both death (8.1%, 24.3%, 33.3%, respectively; p