Prognostic value of semi-quantitative CT-based score integrated with cardiovascular risk factors during the first peak of the COVID-19 pandemic: A new score to predict poor outcome

PURPOSE: Predicting the clinical course of COVID-19 pneumonia is of high clinical importance and may change treatment strategies. This study aimed to compare the semi-quantitative CT score (radiological score), mCHA(2)DS(2)-VASc score (clinical score), and R-mCHA(2)DS(2)-VASc score (clinical and radiological score) to predict the risk of ICU admission and mortality in COVID 19 pneumonia. METHODS: This study retrospectively evaluated 901 COVID-19 pneumonia cases with positive PCR results. The mCHA(2)DS(2)-VASc score was calculated based on clinical risk factors. CT images were evaluated, and the semi-quantitative CT scores were obtained. A new scoring method (R-mCHA(2)DS(2)-VASc score) was developed by combining these scores. The performance of the mCHA(2)DS(2)-VASc score, semi-quantitative CT score, and a combination of these scores (R-mCHA(2)DS(2)-VASc score) was evaluated using ROC analysis. RESULTS: The ROC curves of the semi-quantitative CT, mCHA(2)DS(2)-VASc, and R-mCHA(2)DS(2)-VASc scores were examined. The semi-quantitative CT, mCHA(2)DS(2)-VASc, and R-mCHA(2)DS(2)-VASc scores were significant in predicting intensive care unit (ICU) admission and mortality (p < 0.001). The R-mCHA(2)DS(2)-VASc score performed best in predicting a severe clinical course, and the cut-off value of 8 for the R-mCHA(2)DS(2)-VASc score had 83.9% sensitivity and 91.6% specificity for mortality. CONCLUSIONS: The R-mCHA(2)DS(2)-VASc score includes both clinical and radiological parameters. It is a feasible scoring method for predicting a severe clinical course at an early stage with high sensitivity and specificity values. However, prospective studies with larger sample sizes are warranted.