SARS-COV-ATE risk assessment model for arterial thromboembolism in COVID-19

• Published in: Scientific reports Vol. 12; no. 1; pp. 16176 - 9
• Main Authors: Li, Pin, Lee, Yi, Jehangir, Qasim, Lin, Chun-Hui, Krishnamoorthy, Geetha, Sule, Anupam A., Halabi, Abdul R., Patel, Kiritkumar, Poisson, Laila, Nair, Girish B.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 28.09.2022; Nature Publishing Group; Nature Portfolio
• Subjects: 692/499; 692/699/75/2/1674; Aspartate aminotransferase; Blood pressure; Brain natriuretic peptide; Calcium-binding protein; Cardiovascular diseases; Cerebral infarction; Coronaviruses; COVID-19; Creatinine; Health risks; Humanities and Social Sciences; Interleukin 6; Ischemia; L-Lactate dehydrogenase; Lactic acid; Leukocytes; Magnesium; multidisciplinary; Myocardial infarction; Patients; Prediction models; Risk assessment; Risk factors; Risk groups; Science; Science (multidisciplinary); Severe acute respiratory syndrome coronavirus 2; Stroke; Thromboembolism; Training; Troponin; Vascular diseases
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-022-18510-3

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.