Comparison of CHA2DS2VASc and R2CHA2DS2VASc Score Estimation of In-Hospital Mortality Among COVID-19 Patients

Abstract

Objective: This study aims to compare of CHA(2)DS(2)VASc and R(2)CHA(2)DS(2)VASc c score estimation of in -hospital mortality among COVID-19 patients and find a new scoring system that can better predict the hospital mortality by adding some laboratory parameters to the CHA2DS2VASc and R2CHA2DS2VASc scores. Materials and Methods: This is a cross-sectional study. A total of 1076 COVID-19 patients with confirmed COVID-19 PCR tests were included from September 2020 to March 2021. Age, sex, comorbidity, laboratory, survival times, and death status of the patients were recorded. The scores CHA(2)DS(2)VASc and R(2)CHA(2)DS(2)VASc of each patient were calculated. A new mortality prediction score was created to establish the most effective model with logistic regression analysis, including laboratory values. Results: Of the 1076 patients hospitalized for COVID-19, 15.1% died, while 84.9% survived. There was no significant difference between the two groups in sex. All comorbidities were significantly higher in the deceased than in the survivors (p<0.001). The survivors' hemoglobin, thrombocyte, and eGFR values were significantly higher. The C -reactive protein (CRP), aspartate aminotransferase (AST), and neutrophil-to-lymphocyte ratio (NLR) were found to be associated with mortality, and the CAN-R(2)CHA(2)DS(2)VASc score was created by including these three laboratory parameters. The ROC curves of the scores CHA(2)DS(2)VASc (AUC=0.810), R(2)CHA(2)DS(2)VASc (AUC=0.824), and CANR(2)CHA(2)DS(2)VASc (AUC=0.909) were analyzed. The CAN-R(2)CHA(2)DS(2)VASc score was superior to other scores (p<0.001). The sensitivity and specificity of the CAN-R(2)CHA(2)DS(2)VASc score were 79.8% and 86.5%, respectively, while the criterion was >6 points. Conclusions: The CAN-R(2)CHA(2)DS(2)VASc score is a useful tool for estimating hospital mortality in COVID-19 patients. The CAN-R(2)CHA(2)DS(2)VASc score was superior to the R(2)CHA(2)DS(2)VASc and CHA(2)DS(2)VASc score in predicting in -hospital mortality.