Abstract

Deepan Karthick, M. Divahar, Sathik, Rajmohan and J. A. Jayalal*

ABSTRACT

SARS-COV-2 disease 2019 has emerged as a major global health threat with a great number of deaths in the world amounting to nearly 8 lakhs. In this study we looked for the association between Acute Physiology and Chronic Health Evaluation II score and hospital mortality in patients with coronavirus disease 2019, and to assess the predictive ability of Acute Physiology and Chronic Health Evaluation II score. It is a Retrospective observational cohort study carried out in a teaching hospital Tirunelveli medical college COVID care ward. 100 Confirmed patients with coronavirus disease 2019 as decided by the RTPCR testing and hospitalized in the COVID care unit with moderate to severe infection were included in the study. Of these 100 potentially eligible patients with symptoms of coronavirus disease 2019, 14 patients died and with intensive care all others were cured .The Mean Acute Physiology and Chronic Health Evaluation II score (22.21 ± 6.05) calculated was relatively higher in patients who were succumbed to death with the mean Acute Physiology and Chronic Health Evaluation II score of 9.87 ± 4.40 in patients who have survived the infections (p < 0.001). Acute Physiology and Chronic Health Evaluation II score has shown independent association with the resultant hospital mortality (adjusted hazard ratio, 1.07; 95% CI, 1.01-1.13) and have demonstrated better discriminative ability (area under the curve, 0.966; 95% CI, 0.942-0.990). The cut-off value of above 17, Acute Physiology and Chronic Health Evaluation score could predict the death of the patients with COVID -19 with a sensitivity of 96.15% and specificity of 86.27%. The survivor probability of patients with coronavirus disease 2019 with Acute Physiology and Chronic Health Evaluation II score less than 17 was notably higher and in patients with Acute Physiology and Chronic Health Evaluation II score lesser than 17, they were survived (p < 0.001). Conclusions: For effective clinical prediction of hospital mortality in patients with coronavirus disease 2019, Acute Physiology and Chronic Health Evaluation II score can be used and when the score is greater than or equal to 17, it is an early warning indicator of death and will prompt the physicians to upgrade the treatment protocol.