28. Utilizing the Charleston Comorbidity Index as an Independent Predictor for Outcomes in SARS-Cov-2 Positive Patients

BACKGROUND: Since COVID-19 was declared a pandemic, it has seemed that the virus is nondiscriminatory causing 3.73 million deaths worldwide. The Charleston Comorbidity Index (CCI) is a scoring system predicting the one-year mortality for patients with a range of comorbid conditions and is widely used as a predictor of prognosis and survival for a range of pathologies. This study aims to assess if there is an impact of comorbidity burden on COVID-19 patients by utilizing their CCI score. Charleston Comorbidity Index Score [Image: see text] Scoring system for Charleston Comorbidity Index (CCI). Plus 1 point for every decade age 50 years and over, maximum 4 points. Higher scores indicate a more severe condition and consequently, a worse prognosis. METHODS: Multicenter, retrospective review of patients diagnosed with COVID-19 from January 2020 to September 2020 throughout the HCA Healthcare system. CCI scores for all COVID-19 positive patients were calculated and logistic regression analysis was performed to predict hospitalization and ICU admission by CCI controlling for age, sex and race. A multinomial regression model was also performed to predict discharge status by CCI controlling for age, sex and race. ROC curves to indicate the CCI cut-off point for each outcome (hospitalization, ICU admission and mortality) was performed, and Youden’s Index was used to identify the optimal point. RESULTS: In the study timeframe, 92,800 patients were diagnosed with COVID-19 and of those, 48,270 were hospitalized. A one-point increase in CCI was associated with higher odds of hospitalization [OR 1.718; 95% CI 1.696-1.74]. The threshold for significance to predict hospitalization was a CCI of 1.5 (AUC 0.804, Youden Index 0.48) with a specificity (73%) and sensitivity (75%). A one-point increase in CCI was associated with 1.444 higher odds of an ICU admission (95% CI 1.134-1.155). A one-point increase in CCI significantly increased the odds of discharge to hospice compared to any discharge other than hospice [OR 1.162; 95% CI 1.142-1.182]). A one-point increase in CCI score was associated with 1.188 higher odds of in-hospital mortality (95% CI, 1.173-1.203) with a CCI threshold of 3.5 having the highest specificity (50.9%) and sensitivity (79.9%) to predict mortality outcome (AUC 0.704, Youden Index 0.31). [Image: see text] CONCLUSION: In conclusion CCI score is an adequate predictor of hospitalization and in-hospital mortality but less so in predicting ICU admission in COVID-19 positive patients. DISCLOSURES: All Authors: No reported disclosures