Mortality Risk Assessment Using CHA(2)DS(2)-VASc Scores In Patients Hospitalized With COVID -19 Infection

ABSTRACT Early risk stratification for complications and death related to 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: 2-3;T3: ≥4) revealed increases in both death (8 1%, 24 3%, 33 3%, respectively;p<0 001) and the composite endpoint (18 6%, 31 9%, 43 5%, respectively;p<0 001) The odds ratios(ORs) for mortality and the composite endpoint for T2 patients versus T1 CHA(2)DS(2)-VASc score were 3 62(95% CI:2 29-5 73,p<0 001) and 2 04(95% CI:1 42-2 93, p<0 001), respectively Similarly, the ORs for mortality and the composite endpoint for T3 patients versus T1 were 5 65(95% CI:3 54-9 01,p<0 001) and 3 36(95% CI:2 30-4 90,p<0 001), respectively In conclusion, among Italian patients hospitalized for COVID-19 infection, the CHA(2)DS(2)-VASc risk score for thromboembolic events enhanced the ability to achieve risk stratification for complications and death