Comparison of thromboembolic risk scores for evaluating in-hospital events of COVID-19 patients.

Aim: To compare the effectiveness of thromboembolic risk scores in determining in-hospital events of COVID-19 patients. Methods: This retrospective study included a total of 410 consecutive COVID-19 patients. Scores including CHA2DS2-VASc-HS (congestive heart failure, hypertension, age, diabetes mellitus, stroke/transient ischemic attack, vascular disease, sex, hyperlipidemia, smoking); modified R2CHA2DS2-VASc (CHA2DS2-VASc plus renal function), m-ATRIA (modified Anticoagulation and Risk Factors in Atrial Fibrillation score), ATRIA-HSV (ATRIA plus hyperlipidemia, smoking and vascular disease) and modified ATRIA-HSV were calculated. Participants were divided by in-hospital mortality status into two groups: alive and deceased. Results: Ninety-two (22.4%) patients died. Patients in the deceased group were older, predominantly male and had comorbid conditions. CHA2DS2-VASc-HS (adjusted odds ratio [aOR]: 1.31; p = 0.011), m-R2CHA2DS2-VASc (aOR: 1.33; p = 0.007), m-ATRIA (aOR: 1.18; p = 0.026), ATRIA-HSV (aOR: 1.18; p = 0.013) and m-ATRIA-HSV (aOR: 1.24; p = 0.001) scores were all associated with in-hospital mortality. m-R2CHA2DS2-VASc and modified ATRIA-HSV had the best discriminatory performance. Conclusion: We showed that m-R2CHA2DS2-VASc and m-ATRIA-HSV scores were better than the rest in predicting mortality among COVID-19 patients.

COVID-19 continues to be a pandemic that threatens human health all over the world. The main aim of our study was to examine the relationship between risk scores routinely used to determine the probability of clot formation in various cardiovascular diseases and in-hospital deaths of COVID-19 patients. The study comprised 410 adult patients hospitalized with a confirmed diagnosis of COVID-19. The clinical and laboratory data were obtained from the hospital registry system. All risk scores in the study were significantly greater in people who died from COVID-19 than in those who survived. Moreover, scoring systems that include kidney function outperformed the rest in determining in-hospital death. As a result, we discovered that specific risk scores used to indicate a person's likelihood of developing clot formation at a routine cardiology clinic are connected to in-hospital deaths among hospitalized COVID-19 patients.

HATCH Score for Predicting Mortality in COVID-19 Patients

Background: We aimed to evaluate the relationship between HATCH score [hypertension, age >75 yr, previous transient ischemic attack (TIA) or stroke (doubled), chronic obstructive pulmonary disease, heart failure (doubled)] and in-hospital mortality in COVID-19 patients. Methods: Overall, 572 COVID-19 patients hospitalized between Mar 15 and Apr 15, 2020, were included in this multicenter retrospective study, in Turkey. The HATCH score of each patient was calculated. Mortality results were followed for 50 days. The patients were divided into 2 groups developing mortality (n=267) and non-mortality (n=305). Clinical outcomes were defined as in-hospital mortality improvement status. Results: HATCH scores in non-survivors of COVID-19 were significantly higher than in survivors (P<0.001). In logistic regression analysis, HATCH score (OR: 1.253, 95% CI: 1.003–1.565;P=0.047), platelet count (OR: 0.995, 95% CI: 0.993–0.998;P<0.001), C-reactive protein level (OR: 1.010, 95% CI: 1.007–1.013, P<0.001) and estimated glomerular filtration ratio (eGFR) level (OR: 0.963, 95% CI: 0.953–0.973;P<0.001) were independent predictors of in-hospital mortality in COVID-19 patients. Conclusion: The HATCH score is useful in predicting in-hospital mortality in patients hospitalized with COVID-19.

COVÍD-19 tanısı alan hastalarda yatarak tedavi görmeyi öngörmede 3 prediktör: yaş, laktat dehidrogenaz ve nötrofil/lenfosit oranı

et Amaç: Aralik 2019’da Çin’in Hubei eyaleti Wuhan’da nedeni bilinmeyen pnömoni salgını yaşandı ve bu hastalık Dünya Sağlık Örgütü (WHO) tarafından koronavirüs hastalığı (COVÍD-19) olarak adlandırıldı. COVÍD-19 hızlıca dünyaya yayıldı. Bu hastalık hastalarda farklı şiddette seyretmektedir. Bu nedenle hastalar yatarak tedavi veya ayaktan tedavi gibi farklı alternatifler ile tedavi edilmektedir. Bu çalışmada bizim amacımız biyokimyasal parametreler ile hastaların ayakta tedavi veya yatarak tedavi almasındaki ilişkiyi araştırmaktır. Gereç ve yöntem: Çok merkezli retrospektif kohort çalışmamızda hastalar iki gruba ayrıldı;yatan hastalar ve ayaktan tedavi alan hastalar. Yatarak tedavi alan 60 hasta olmak üzere 102 hasta çalışmaya alındı. Koronavirüs;WHO’nun kılavuzuna göre gerçek zamanlı polimeraz zincir reaksiyonu (PZR) yöntemiyle SARS-CoV-2 RNA saptanmasıyla belirlenmiştir. Kan parametrelerinde nötrofil/lenfosit oranı (NLR) hesaplanmıştır. Bulgular: Yatan hasta grubunda daha ileri yaş (32,0 (26,0-39,3);54,0 (38,3-59,3), p<0,001), kan değerlerinde daha yüksek laktat dehidrogenaz (LDH) (195,0 (156,5-225,3);248,5 (200,3-334,5), p<0,001) ve daha yüksek NLR (1,56 (1,08-2,62);2,60 (1,65-4,90), p<0,001) görüldü. Sonraki adımda lojistik regresyon analizinde;ileri yaş (OR:1,072 95 % CI:1,031-1,115, p=0,001), yüksek LDH (OR:1,021 95 %CI:1,009-1,034, p=0,001) yüksek NLR (OR:1,402 95 % CI:1,049-1,874, p=0,023) yatarak tedavi almayı bağımsız olarak predikte etti. Sonuç: COVÍD-19 hastalarında ileri yaş, yüksek LDH ve yüksek NLR değerleri hastanede yatarak tedavi almayı öngördürmüştür. COVID- 19 continues to spread rapidly all over the world. Patients may experience the disease at different severity. Therefore, they can be treated by choosing alternative approaches including outpatient treatment or hospitalization. Our aim in the present study is to investigate the relationship between some biochemical parameters on admission and treatment location preference (inpatient or outpatient) Materials and methods: At our multi-center retrospective cohort study, we divided the study into 2 groups as inpatients and outpatients. A total of 102 patients, 60 of whom received inpatient treatment, were enrolled. Coronavirus was determined by detecting SARS-CoV-2 RNA with a real-time PCR method in accordance with the WHO guide. Blood parameters were recorded and NLR was calculated. Results: Inpatient group was older (32.0 (26.0-39.3) vs 54.0 (38.3-59.3), p<0.001) and had significantly higher level of LDH (195.0 (156.5-225.3) vs 248.5 (200.3-334.5), p<0.001) and NLR (1.56 (1.08-2.62) vs 2.60 (1.65-4.90), p<0.001) in blood samples. In forward stepwise logistic regression analysis;advanced age (OR:1.072 95 % CI:1.031-1.115, p=0.001), high LDH (OR:1.021 95 %CI:1.009-1.034, p=0.001) and NLR (OR:1.402 95 % CI:1.049-1.874, p=0.023) were shown as independent predictors of hospitalization Conclusion: Advanced age, high LDH, and NLR level predicted hospitalization in patients with COVID-19. Keywords: Coronavirus, laktate dehydrogenase, neutrophil/ lymphocyte ratio (NLR)

The Neutrophil to Lymphocyte Ratio and In-Hospital All-Cause Mortality in Patients with COVID-19

Objective: In December 2019, pneumonia associated with severe acute respiratory syndrome coronavirus 2 emerged in China, and has been spread worldwide eventuating the coronavirus disease 2019 (COVID-19) pandemic. As of June 27, 2020, 195,883 people have been diagnosed with COVID-19 in Turkey, among them 5082 are dead. Moreover, 9,999,606 people were infected worldwide. The neutrophil-to-lymphocyte ratio (NLR) has been reported as an inflammatory biomarker. This study aimed to evaluate the relationship between NLR on admission and in-hospital all-cause mortality in adult patients with COVID-19. Methods: This retrospective cohort study included a total of 455 COVID-19 patients from Turkey. The diagnosis of COVID-19 was made according to the World Health Organization's interim guidance and confirmed by RNA detection of SARS-CoV-2. The NLR was calculated for each patient. Results: The NLR on admission was found to be significantly higher in nonsurvivor COVID-19 patients than survivors (12.3 [0.8-137.3] vs. 3.2 [0.6-79.0], p<0.001). Forward stepwise logistic regression analysis was carried out to determine the independent predictors of in-hospital all-cause mortality of patients with COVID-19. The analysis demonstrated that age [odds ratio (OR)=1.203, 95% confidence interval (CI): 1.027-1.408, p=0.022], NLR (OR=1.261, 95% CI: 1.054-1.509, p=0.011), lactate dehydrogenase level (OR=1.013, 95% CI: 1.004-1.022, p=0.005), glomerular filtration rate (OR=0.920, 95% CI: 0.853-0.992, p=0.030), alanine transaminase level (OR=1.107, 95% CI: 1.011-1.212, p=0.028), and aspartate transaminase level on admission (OR=0.939, 95% CI: 0.8880.993, p=0.027) were independent predictors of in-hospital all-cause mortality of patients with COVID-19. In the receiver operating characteristic curve analysis, the sensitivity and specificity of the NLR for predicting in-hospital all-cause mortality were found to be 92% and 53%, respectively, at the cut-off value of 3. Conclusion: The NLR on admission predicts in-hospital all-cause mortality of patients with COVID-19.

The CHA2DS2-VASc score and in-hospital mortality in patients with COVID-19: A multicenter retrospective cohort study.

OBJECTIVE: Coronavirus disease 2019 (COVID-19) is an infectious disease that was first reported in December 2019 in Wuhan, China, and has since spread rapidly around the world, resulting in the ongoing COVID-19 pandemic. The CHA2DS2-VASc score is a well-validated risk stratification tool for predicting stroke in atrial fibrillation (AFib), as well as morbidity and mortality in several entities. The aim of this study was to evaluate the relationship between the CHA2DS2-VASc score and in-hospital mortality in patients with COVID-19, regardless of AFib. METHODS: This multicenter, retrospective study included a total of 349 patients with COVID-19 who were hospitalized between March 15 and April 15, 2020. The CHA2DS2-VASc score of each patient was calculated. Mortality outcomes were followed up until April 25, 2020. RESULTS: The CHA2DS2-VASc score was significantly higher in non-survivor COVID-19 patients than in survivor COVID-19 patients (p<0.001). Forward stepwise logistic regression analysis demonstrated that a CHA2DS2-VASc score of ≥3 (odds ratio [OR]: 12.613, 95% confidence interval [CI]: 3.092-51.451; p<0.001), and the leukocyte count (OR: 1.327, 95% CI: 1.145-1.538; p<0.001), C-reactive protein level (OR: 1.010, 95% CI: 1.002-1.018; p=0.012), and ferritin level (OR: 1.005, 95% CI: 1.003-1.007; p<0.001) on admission were independent predictors of in-hospital mortality of COVID-19 patients. CONCLUSION: The CHA2DS2-VASc score predicted in-hospital mortality in patients with COVID-19, regardless of AFib.