The C2HEST score on admission to hospital may successfully predict the clinical outcomes of COVID-19 in all-comers population

IF 3 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Archives of Medical Science Pub Date : 2024-07-28 DOI:10.5114/aoms/190744

A. Doroszko, M. Trocha, Krzysztof Kujawa, Jędrzej Machowiak, Anna Jodkowska, Piotr Rola, Jarosław Sowizdraniuk, Paweł Lubieniecki, Mariusz Koral, Agata Stanek, J. Sokołowski, E. A. Jankowska, K. Madziarska

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引用次数: 0

Abstract

Since the beginning of SARS-CoV-2-pandemic, intensive efforts have been made to identify predictors of COVID-19 outcomes. Individual components of the C2HEST-scale, used to predict the risk of atrial fibrillation, reflect comorbidities presences. Therefore, we hypothesized that the score could predict unfavorable clinical COVID-19-outcomes.2184-medical-records of subjects hospitalized at the medical-university-center due to COVID-19 from February 2020 to June 2021 were retrospectively analyzed . The subjects were categorized into low/medium/high-risk categories according to the C2HEST scale. Measured outcomes included: in-hospital-, 3-month- and 6-month-all-cause-mortality, the non-fatal hospitalization endpoints and other adverse in-hospital events.A total of 598 deaths (27.4%), including 326 in-hospital (15%) were reported. All three types of mortality were highest in the high-risk C2HEST-stratum (35.4%, 54.4, and 56.9%), ,and lowest in the low-risk-stratum: (8.4%, 15%, and 37.5%), respectively. The receiver-operating characteristics revealed that C2HEST allows one to predict 1-month mortality with AUC30=70.7 and maintained at a similar level after 3- and 6-month-observation(AUC90=72.0 and AUC180=67). The p-value for the Log-rank test comparing survival curves was <0.0001. An increase of one C2HEST-point raised the overall death rate 1.4-fold. A change from the low- to medium category increased the death rate 3.4 times, while between the low- and high-risk-stratum the hazard-ratio was 5.0. The C2HEST-score also revealed predictive value for pneumonia, sepsis, cardiogenic-shock, myocardi-injury, acute heart failure, kidney/liver-injury, stroke, gastrointestinal-bleedings.The C2HEST-score is usefull in predicting adverse COVID-19-outcomes in hospitalized subjects. The simplicity of this scale, based on the presence of comorbidities, may address medical needs in risk stratification of COVID-19- patients.

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入院时的 C2HEST 评分可成功预测 COVID-19 在所有患者中的临床结果

自 SARS-CoV-2 大流行以来，人们一直在努力确定 COVID-19 结果的预测因素。用于预测心房颤动风险的 C2HEST 量表的各个组成部分反映了合并症的存在。我们对 2020 年 2 月至 2021 年 6 月期间因 COVID-19 在医科大学中心住院的 2184 名受试者的医疗记录进行了回顾性分析。根据C2HEST量表，受试者被分为低/中/高风险类别。测量结果包括：院内、3个月和6个月全因死亡率、非致死性住院终点和其他院内不良事件。据报道，共有598例死亡（27.4%），其中包括326例院内死亡（15%）。所有三种死亡率在高风险的C2HEST组中最高（分别为35.4%、54.4%和56.9%），而在低风险组中最低：分别为8.4%、15%和37.5%。接受者操作特征显示，C2HEST 可以预测 1 个月的死亡率，AUC30=70.7，并且在 3 个月和 6 个月的观察后保持在相似的水平（AUC90=72.0 和 AUC180=67）。比较生存曲线的对数秩检验的 p 值小于 0.0001。C2HEST点每增加一个，总死亡率就会增加1.4倍。从低危等级到中危等级，死亡率增加了 3.4 倍，而低危等级和高危等级之间的危险比为 5.0。C2HEST 评分还显示了对肺炎、败血症、心源性休克、心肌损伤、急性心力衰竭、肾/肝损伤、中风、胃肠道出血的预测价值。该量表以是否存在合并症为基础，简单易用，可满足对 COVID-19 患者进行风险分层的医疗需求。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of Medical Science 医学-医学：内科

CiteScore

4.90

自引率

7.90%

发文量

139

审稿时长

1.7 months

期刊介绍： Archives of Medical Science (AMS) publishes high quality original articles and reviews of recognized scientists that deal with all scientific medicine. AMS opens the possibilities for young, capable scientists. The journal would like to give them a chance to have a publication following matter-of-fact, professional review by outstanding, famous medical scientists. Thanks to that they will have an opportunity to present their study results and/or receive useful advice about the mistakes they have made so far. The second equally important aim is a presentation of review manuscripts of recognized scientists about the educational capacity, in order that young scientists, often at the beginning of their scientific carrier, could constantly deepen their medical knowledge and be up-to-date with current guidelines and trends in world-wide medicine. The fact that our educational articles are written by world-famous scientists determines their innovation and the highest quality.