Clin Res Cardiol (2022). https://doi.org/10.1007/s00392-022-02002-5

Risk assessment in COVID-19: Prognostic importance of cardiovascular parameters
M. Zdanyte1, P. Martus2, J. Nestele1, A. Bild1, L. Mizera1, A. Glatthaar1, Á. Petersen Uribe1, T. Geisler1, K. A. L. Müller1, M. Gawaz1, D. Rath1
1Innere Medizin III, Kardiologie und Kreislauferkrankungen, Universitätsklinikum Tübingen, Tübingen; 2Institut für Klinische Epidemiologie und angewandte Biometrie, Universitätsklinikum Tübingen, Tübingen;

AIMS: Cardiovascular risk factors and comorbidities are highly prevalent among COVID-19 patients and are associated with worse outcomes. We therefore investigated if established cardiovascular risk assessment models could efficiently predict adverse outcomes in COVID-19. Furthermore, we aimed to generate novel risk scores including various cardiovascular parameters for prediction of outcomes in COVID-19.
METHODS AND RESULTS: A total of 441 consecutive patients diagnosed with SARS-CoV-2 infection were followed-up for 30 days after hospital admission for a combined endpoint, which consisted of first manifestation of either all-cause mortality (ACM) and/or venous/arterial thromboembolism, and secondary endpoints comprising ACM, mechanical ventilation and venous/arterial thromboembolism. Discrimination performance of DAPT, GRACE 2.0, PARIS-CTE, PREDICT-STABLE, CHA2-DS2-VASc, HAS-BLED, PARIS-MB, PRECISE-DAPT scores for selected endpoints was evaluated by ROC-analysis which showed that GRACE 2.0 score performed best in predicting combined endpoint and ACM. Novel risk assessment models including age, reduced right ventricular function, moderate/severe tricuspid regurgitation, arterial hypertension, D-dimer, C-reactive protein, procalcitonin, troponin I, lactate dehydrogenase and/or N-terminal prohormone of brain natriuretic peptide, were generated and could successfully predict combined endpoint (AUC=0.830), ACM (AUC=0.827), venous/arterial thromboembolism (AUC=0.774) and need for mechanical ventilation (AUC=0.862).
CONCLUSION: Novel risk assessment models including age, laboratory parameters, cardiovascular risk factors and echocardiographic parameters showed good discrimination performance for adverse outcomes in COVID-19. The newly developed scores outweighed discrimination performance of established cardiovascular risk assessment models.



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