The Impact of Charlson Comorbidity Index on mortality from SARS-CoV-2
virus infection and A novel COVID 19 mortality index: CoLACD
Abstract
Objective: The aim of this study is to find out the potential risk
factors including Charlson Comorbidity index (CCI) score associated with
death in COVID-19 cases hospitalized due to pneumonia and try to find a
novel COVID-19 mortality score for daily use. Methods: All patients
diagnosed as confirmed or probable COVID-19 pneumonia whom hospitalized
in our Chest Diseases Education and Research Hospital between March 11,
2020 and May 15,2020 were enrolled. The optimal cut-off values,
sensitivity and specificity values and odds ratios to be used in
mortality prediction of the novel scoring system created from these
parameters were calculated by ROC analysis according to the area under
the curve and Youden index. Results: Over 383 patients (n:33 deceased,
n:350 survivors) univariate and multivariate regression analysis showed
that CCI and lymphocyte ratio were prognostic factors for COVID-19
related mortality. Using this analysis, a novel scoring model CoLACD
(CoVID-19 Lymphocyte ratio, Age, CCI score, Dyspnea) was established.
The cut-off value of this scoring system, which determines the mortality
risk in patients, was 2.5 points with 82% sensitivity and 73%
specificity (AUC = 0.802, 95% CI 0.777-0.886, p <0.001). The
risk of mortality was 11.8 times higher in patients with a CoLACD
mortality score higher than 2.5 points than patients with a score lower
than 2.5 (OR = 11.8 95% CI 4.7-29.3 p <0.001). Conclusion:
This study showed that by using the CoLACD mortality score, clinicians
may achieve a prediction of mortality in COVID-19 patients hospitalized
for pneumonia.