Usefulness of C2HEST Score in Predicting Clinical Outcomes of COVID-19 in Heart Failure and Non-Heart-Failure Cohorts

Journal of Clinical Medicine

Tomasz Skalec¹  Barbara Adamik¹  Stanisław Zieliński¹  Janusz Sokołowski²  Anna Zubkiewicz-Zarębska³  Krzysztof Kaliszewski⁴  Michał Pomorski⁵  Tomasz Matys⁶  Damian Gajecki⁶  Adrian Doroszko⁶  Jakub Gawryś⁶  Katarzyna Madziarska⁷  Katarzyna Kiliś-Pstrusinska⁸  Agata Sebastian⁹  Marcin Madziarski⁹  Piotr Rola^1,10  Szymon Włodarczak^1,11  Małgorzata Trocha^1,12  Jarosław Drobnik^1,13  Marcin Protasiewicz^1,14  Ewa Anita Jankowska^1,14  Agnieszka Matera-Witkiewicz^1,15  Krzysztof Kujawa^1,16  Katarzyna Giniewicz^1,16 

[1] Clinical Department of Anaesthesiology and Intensive Therapy, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland;Clinical Department of Emergency Medicine, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland;Clinical Department of Gastroenterology and Hepatology, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland;Clinical Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland;Clinical Department of Gynecology and Obstetrics, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland;Clinical Department of Internal Medicine, Hypertension and Clinical Oncology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland;Clinical Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland;Clinical Department of Paediatric Nephrology, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland;Clinical Department of Rheumatology and Internal Medicine, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland;Department of Cardiology, Provincial Specialized Hospital, Iwaszkiewicza Street 5, 59-220 Legnica, Poland;Department of Cardiology, The Copper Health Centre (MCZ), 59-300 Lubin, Poland;Department of Pharmacology, Wroclaw Medical University, Mikulicz-Radecki Street 2, 50-345 Wroclaw, Poland;Department of Population Health, Division Epidemiology and Health Education, Wroclaw Medical University, Bujwida Street 44, 50-368 Wroclaw, Poland;Institute of Heart Diseases, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland;Screening of Biological Activity Assays and Collection of Biological Material Laboratory, Wroclaw Medical University Biobank, Wroclaw Medical University, Borowska Street 211A, 50-556 Wroclaw, Poland;Statistical Analysis Centre, Wroclaw Medical University, K. Marcinkowski Street 2-6, 50-368 Wroclaw, Poland;

关键词: heart failure;    COVID-19;    SARS-CoV-2;    outcomes;    C₂HEST score;    mortality;   

DOI  :  10.3390/jcm11123495

来源: DOAJ

【 摘 要 】

Background: Patients with heart failure represent a vulnerable population for COVID-19 and are prone to having worse prognoses and higher fatality rates. Still, the clinical course of the infection is dynamic, and complication occurrence in particular in patients with heart failure is fairly unpredictable. Considering that individual components of the C₂HEST (C2: Coronary Artery Diseases (CAD)/Chronic obstructive pulmonary disease (COPD); H: Hypertension; E: Elderly (Age ≥ 75); S: Systolic HF; T: Thyroid disease) are parallel to COVID-19 mortality risk factors, we evaluate the predictive value of C₂HEST score in patients with heart failure (HF) Material and Methods: The retrospective medical data analysis of 2184 COVID-19 patients hospitalized in the University Hospital in Wroclaw between February 2020 and June 2021 was the basis of the study. The measured outcomes included: in-hospital mortality, 3-month and 6-month all-cause-mortality, non-fatal end of hospitalization, and adverse in-hospital clinical events. Results: The heart failure cohort consists of 255 patients, while 1929 patients were assigned to the non-HF cohort. The in-hospital, 3-month, and 6-month mortality rates were highest in the HF cohort high-risk C₂HEST stratum, reaching 38.61%, 53.96%, and 65.36%, respectively. In the non-HF cohort, in-hospital, 3-month, and 6-month mortalities were also highest in the high-risk C₂HEST stratum and came to 26.39%, 52.78%, and 65.0%, respectively. An additional point in the C₂HEST score increased the total death intensity in 10% of HF subjects (HR 1.100, 95% CI 0.968–1.250 p = 0.143) while in the non-HF cohort, the same value increased by 62.3% (HR 1.623, 95% CI 1.518–1.734 p < 0.0001). Conclusions: The C₂HEST score risk in the HF cohort failed to show discriminatory performance in terms of mortality and other clinical adverse outcomes during hospitalization. C₂HEST score in the non-HF cohort showed significantly better performance in terms of predicting in-hospital and 6-month mortality and other non-fatal clinical outcomes such as cardiovascular events (myocardial injury, acute heart failure, myocardial infarction, cardiogenic shock), pneumonia, sepsis, and acute renal injury.

【 授权许可】

Unknown