Abstract
Introduction: The current pandemic with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has impacted healthcare around the globe. The CHADS2VASC and frailty scores have not been studied as tool predictors for outcomes in this population. Hypothesis: CHA2DS2VASC and frailty scores can be used as predictors of mortality and unfavorable outcomes in patients hospitalized with SARS-CoV-2 infection. Methods: We included patients ages 18 years and older who required in-hospital treatment for SARS-CoV-2 infection at a Community Hospital between February and April of 2020. CHA2DS2VASC score and frailty index (FI) were calculated at time of admission and were used as continuous variables in a multivariate logistic regression model. Cardiovascular (CV) outcome was a composite variable that included non-fatal MI, decompensated heart failure, unstable arrhythmia and CVA. Results: Amongst 109 patients, 55% were male, mean age was 61.7 years (standard deviation 17.7) and 73% of the patients were admitted from home. 21.1% (23) of the patients died during their stay. The mean CHA2DS2VASC score was 2.5 (SD 1.7). For every point increase in the CHA2DS2VASC score the odds of mortality increased by 78% (aOR 1.78; 95% CI; 1.07-2.97). The mean frailty score was 6.2 (SD 5.7). For every point increase in the frailty score the odds of mortality increased by 22% (aOR: 1.22; 95% CI 1.07-1.39) [Figure]. There was a trend between higher CHA2DS2VASC and frailty scores with worse CV outcomes during hospital stay but this did not meet statistical significance (aOR: 1.31; 95% CI 0.86-2.0, aOR: 1.04; CI 0.93-1.17 respectively). Conclusions: Higher CHA2DS2VASC and frailty scores are associated with increased risk of mortality. Although statistical significance was not reached for predicting CV outcomes, this was likely related to a small sample size. CHA2DS2VASC and frailty scores are a readily available and novel tool that can be used to predict mortality in hospitalized patients.
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