The ATRIA score is superior to the m-CHA2DS2-Vasc score in predicting in-hospital mortality in COVID-19

Abstract

OBJECTIVE: Coronavirus disease 2019 (COVID-19) has become a health and social problem all over the world. Most of the deaths occur from embolism and thrombus formation. We aimed to compare the predictive value of the anticoagulation and risk factors in atrial fibrillation (ATRIA) and m-CHA2DS2-Vasc scores in in-hospital mortality in COVID-19. METHODS: Three-hundred and ninety-four patients who were hospitalized due to COVID-19 between 10 June 2020 and 10 September 2020 were included. Three-hundred and sixty patients who survived were defined as the non-mortality group and the remaining 34 whose hospitalizations resulted in death were defined as the mortality group. The anticoagulation and risk factors in atrial fibrillation and m-CHA2DS2-Vasc scores of the patients were calculated. RESULTS: A total of 394 patients, mean age 66.2 }9.7 (221 male [56.1%]) were included in this retrospective study. The median values of the anticoagulation and risk factors in atrial fibrillation and m-CHA2DS2-Vasc scores were different between the groups (p<0.000 for both). The multivariate logistic regression analysis showed that both the m-CHA2DS2-Vasc and anticoagulation and risk factors in atrial fibrillation scores were independent predictors of in-hospital mortality (p=0.024, 95%CI 1.039-1.704 for anticoagulation and risk factors in atrial fibrillation and p=0.043, 95%CI 1.012-2.088 for m-CHA2DS2-Vasc). In the receiver operating characteristic curve analysis, the anticoagulation and risk factors in atrial fibrillation score was superior to the m-CHA2DS2-Vasc score with an AUC 0.774 and SE:0.037, and p<0.001. CONCLUSIONS: In our study, we showed that the anticoagulation and risk factors in atrial fibrillation and m-CHA2DS2-Vasc scores can be used as predictors of thrombosis and mortality in COVID-19 patients. In addition, the predictive value of the anticoagulation and risk factors in atrial fibrillation score was higher than that of m-CHA2DS2-Vasc. The use of the anticoagulation and risk factors in atrial fibrillation score to assess high-risk patients in COVID-19 may be recommended.