SARS-COV-ATE risk assessment model for arterial thromboembolism in COVID-19.
Pin LiYi LeeQasim JehangirChun-Hui LinGeetha KrishnamoorthyAnupam A SuleAbdul R HalabiKiritkumar PatelLaila PoissonGirish B NairPublished in: Scientific reports (2022)
Patients with SARS-CoV-2 infection are at an increased risk of cardiovascular and thrombotic complications conferring an extremely poor prognosis. COVID-19 infection is known to be an independent risk factor for acute ischemic stroke and myocardial infarction (MI). We developed a risk assessment model (RAM) to stratify hospitalized COVID-19 patients for arterial thromboembolism (ATE). This multicenter, retrospective study included adult COVID-19 patients admitted between 3/1/2020 and 9/5/2021. Among 3531 patients from the training cohort, 15.5% developed acute in-hospital ATE, including stroke, MI, and other ATE, compared to 13.4% in the validation cohort. The 16-item final score was named SARS-COV-ATE (Sex: male = 1, Age [40-59 = 2, > 60 = 4], Race: non-African American = 1, Smoking = 1 and Systolic blood pressure elevation = 1, Creatinine elevation = 1; Over the range: leukocytes/lactate dehydrogenase/interleukin-6, B-type natriuretic peptide = 1, Vascular disease (cardiovascular/cerebrovascular = 1), Aspartate aminotransferase = 1, Troponin-I [> 0.04 ng/mL = 1, troponin-I > 0.09 ng/mL = 3], Electrolytes derangement [magnesium/potassium = 1]). RAM had a good discrimination (training AUC 0.777, 0.756-0.797; validation AUC 0.766, 0.741-0.790). The validation cohort was stratified as low-risk (score 0-8), intermediate-risk (score 9-13), and high-risk groups (score ≥ 14), with the incidence of ATE 2.4%, 12.8%, and 33.8%, respectively. Our novel prediction model based on 16 standardized, commonly available parameters showed good performance in identifying COVID-19 patients at risk for ATE on admission.
Keyphrases
- sars cov
- poor prognosis
- respiratory syndrome coronavirus
- risk assessment
- blood pressure
- acute ischemic stroke
- african american
- long non coding rna
- heart failure
- left ventricular
- coronavirus disease
- emergency department
- risk factors
- heavy metals
- healthcare
- metabolic syndrome
- heart rate
- type diabetes
- smoking cessation
- cross sectional
- climate change
- adipose tissue
- peripheral blood
- skeletal muscle
- blood brain barrier
- cerebral ischemia
- respiratory failure
- double blind
- insulin resistance
- acute care
- solid state