Prognostic Value of Charlton’s Weighted Index of Capabilities Combined with Chronic Health Evaluation II Score in COVID-19：a retrospective cohort study

Abstract

Background: Since December 2019, coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread across the world. Age and underlying diseases have been reported as predictors of mortality in 2019-nCoV infection. Charlson's weighted index of comorbidities (WIC) and acute physiology and chronic health evaluation (APACHE) II are two frequently-used measures of comorbidity. In this study, we have assessed the performance of WIC and APACHE II in predicting the mortality of COVID-19 patients.Methods: A total of 76 adult patients with COVID-19 were admitted to a designated hospital in Huangshi province from 1 January 2020 to 29 February 2020. Clinical data including age, gender, underlying diseases, and hospital mortality were collected. The APACHE II and WIC scores were assessed within the first 24 hours of admission. Univariate and multiple logistic regression analyses were used to compare the performance of WIC, APACHE II, and joint detection. The area under the receiver operating characteristic curve (AUC) was used to predict the hospital mortality. Results: Of the 76 enrolled patients, 57 patients survived, and 19 died. The surviving patients had significantly lower WIC and APACHE II than the non-surviving patients (p-value < 0.05). The AUC for the hospital mortality was 0.814 (95% confidence interval (CI) 0.705-0.923) of WIC, 0.854 (95% CI 0.705-0.956) of APACHE II and 0.891(95% CI 0.830-0.966) for the joint detection. The diagnostic value of the joint detection was found to be better than that of WIC (p-value= 0.002) or APACHE II (p-value = 0.042). Conclusions: The WIC and APACHE II scores might serve as independent determinants for the hospital mortality associated with COVID-19 patients. The combined use of WIC and APACHE II is more predictive than individuals．