Abstract
OBJECTIVE: The Coronavirus disease (COVID-19) pandemic affected millions of people worldwide and caused hundreds of thousands of deaths. The CHA₂DS₂-VASc score is a scoring system used to determine the indication for anticoagulation in patients with atrial fibrillation (AF) and determines the risk of stroke. Previous studies have shown that it predicts mortality in COVID-19 patients well. New guidelines simplified the score as the CHA₂DS₂-VA score, which is free of sex factor. In this study, we planned to investigate the ability of this simplified score in predicting mortality and intensive care unit (ICU) admission in COVID-19 patients. MATERIALS AND METHODS: All patients who were diagnosed with COVID-19 between January 2021 and January 2022 were screened, and patients with accessible data were enrolled. A total of 838 patients were included. The baseline characteristics of the patients and CHA₂DS₂-VA scores were recorded, and their relationship with poor outcomes was investigated. Mann-Whitney U and T-test were used for continuous variables, while logistic regression and ROC analysis were performed to identify predictors of 1-year mortality and ICU admission. RESULTS: The mean age of the study population was 53.8 ± 18.5, and 53.6% of them (n = 449) were male. Intensive care unit (ICU) admission was present in 177 (21.1%) patients. 1-year mortality was present in 86 (10.3%) patients. Univariable regression analysis revealed that hypertension, diabetes mellitus, coronary artery disease, heart failure, atrial fibrillation, COPD, CHA(2)DS(2)-VA score, glomerular filtration rate, and albumin level were predictors of 1-year mortality. In multivariate regression analysis, only the CHA₂DS₂-VA score was predictive of 1-year mortality (OR = 1.63, 95% CI: 1.05-2.55; p = 0.029). Cut-off value of CHA(2)DS(2)-VA score for predicting 1-year mortality was found to be ≥ 3 (AUC:0.863, p < 0.001) with 75% sensitivity and 81% specificity. A CHA₂DS₂-VA score of ≥ 2 (AUC = 0.725, p < 0.001) constituted the cut-off value for intensive care admission with 61% sensitivity and 74% specificity. CONCLUSIONS: As a result of our study, we found that the CHA₂DS₂-VA score is an independent predictor of 1-year mortality following COVID-19 disease. Cut-off values of the CHA(2)DS(2)-VA score may help identify patients with an increased likelihood of ICU admission and 1-year mortality, although its predictive value may be limited in lower-risk populations.