Abstract

Background

Prediction of hospital mortality in patients with COVID-19 by the CHA2DS2VASc (M-CHA2DS2VASc) has been recently shown. Because COVID-19 patients with acute cardiac injury have higher mortality compared to those without, we assumed that this risk score may also predict acute cardiac injury in these patients.

Methods

In this retrospective, single centre cohort study, we included 352 hospitalised patients with laboratory-confirmed COVID-19 and divided into three groups according to M-CHA2DS2VASc risk score which was created by changing gender criteria of the CHA2DS2VASc from female to male (Group 1, score 0–1 (n = 142); group 2, score 2–3 (n = 138) and group 3, score ≥4 (n = 72)).

Results

As the M-CHA2DS2VASc risk score increased, acute cardiac injury was also significantly increased (Group 1, 11.3%; group 2, 48.6%; group 3, 76%; p < 0.001). The higher M-CHA2DS2VASc tertile had higher prevalence of arrhythmias compared to lower tertile. The multivariate logistic regression analysis showed that M-CHA2DS2VASc risk score, admission to intensive care unit and invasive mechanical ventilation were independent predictors of acute cardiac injury (p = 0.001, odds ratio 1.675 per scale for M-CHA2DS2VASc). In receiver operating characteristic analysis, M-CHA2DS2VASc risk score was able to predict acute cardiac injury (Area under the curve value for acute cardiac injury was 0.80; p < 0.001).

Conclusion

Admission M-CHA2DS2VASc risk score was associated with acute cardiac injury in hospitalised patients with COVID-19.

中文翻译：

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增加改良 CHA2DS2-VASc 风险评分与住院 COVID-19 患者的急性心脏损伤相关

摘要

背景

最近显示了 CHA2DS2VASc (M-CHA2DS2VASc) 对 COVID-19 患者住院死亡率的预测。因为与没有急性心脏损伤的 COVID-19 患者相比，患有急性心脏损伤的患者死亡率更高，我们假设该风险评分也可以预测这些患者的急性心脏损伤。

方法

在这项回顾性、单中心队列研究中，我们纳入了 352 名经实验室确诊的 COVID-19 住院患者，并根据 M-CHA2DS2VASc 风险评分分为三组，该评分是通过将 CHA2DS2VASc 的性别标准从女性更改为男性而创建的（第 1 组） ，得分 0-1（n  = 142）；第 2 组，得分 2-3（n  = 138）和第 3 组，得分 ≥4（n  = 72））。

结果

随着 M-CHA2DS2VASc 风险评分的增加，急性心脏损伤也显着增加（第 1 组，11.3%；第 2 组，48.6%；第 3 组，76%；p  < 0.001）。与较低的三分位数相比，较高的 M-CHA2DS2VASc 三分位数的心律失常患病率较高。多变量逻辑回归分析显示，M-CHA2DS2VASc 风险评分、入住重症监护病房和有创机械通气是急性心脏损伤的独立预测因素（ M-CHA2DS2VASc 的优势比为 1.675/量表）。在接受者操作特征分析中，M-CHA2DS2VASc 风险评分能够预测急性心脏损伤（急性心脏损伤的曲线下面积值为 0.80；p  < 0.001）。

结论

入院 M-CHA2DS2VASc 风险评分与 COVID-19 住院患者的急性心脏损伤相关。