The Prognostic Value of Ichikado Scores and Cci for Hospitalized Patients with Covid-19 Pneumonia

ABSTRACT

INTRODUCTION: As the world continues to experience waves of COVID-19 infections including new variants of the pathogen, it remains an important area of study to fully describe the etiology and associations of the severe disease. Recent studies have established correlations for Charlson Comorbidity Index (CCI) >3 with poor prognosis. Additionally, a previous study has shown that a high Ichikado CT score (ICTS) >172 predicts mortality. Here we further explore the validity of these prognostic tools when used together. METHOD(S) Single-center retrospective cohort data of patients with confirmed COVID pneumonia hospitalized between March 2020 and February 2022 was analyzed. Patients were included if, within 24 hours of admission, a CT Chest and full past medical history were obtained. ICTS was interpreted by 3 radiologists blinded to the outcomes. Thorough review of medical records provided information for CCI calculations. Primary outcomes measured were mortality and length of admission. Multivariate analysis performed using SPSS 28. RESULT(S) Data included eight hundred and seventythree patients (44.1% Female, mean age=55). Multivariate analysis for clinical outcomes of death comparing ICTS and CCI revealed a significant reduction in survival of patients with CCI>3 for ICTS>172 (log rank chi2=18.38, p< 0.001). Estimated survival time for these patients was 17.5 days (SE=0.996, 95%CI 15.527-19.430) compared to CCI< 2 for ICTS>172 which estimated 26.4 days (SE=1.54, 95%CI 23.405-29.441). For ICTS< 171, overall estimated survival was 33.5 days (SE=2.294, 95%CI 28.972-37.966). ROC analysis using predicted survivability showed 75% sensitivity and 65% specificity (AUC=0.762, SE=0.021, p< 0.001, 95%CI 0.720-0.804). CONCLUSION(S) As the number of confirmed COVID-19 cases continues to remain prevalent, practitioners may use these tools to guide the aggressiveness of their treatments and indications for tertiary care. ICTS and CCI are good predictors of COVID-19 prognosis especially when combined. Additionally, these tools can help firstline providers confidently assess and plan these seemingly complicated cases. Further research in this topic may lead to a prognostic tool specific to acute covid cases that is able to determine the prognosis for hospitalization, intubation, and mortality.