2026-07-22T03:37:00Zhttps://repisalud.isciii.es/rest/oai/requestoai:repisalud.isciii.es:20.500.12105/142382025-05-05T17:28:52Zcom_20.500.12105_2052com_20.500.12105_2051com_20.500.12105_15322col_20.500.12105_19609col_20.500.12105_16963col_20.500.12105_16978
Repisalud
author
Perez-Garcia, Felipe
author
Bailén, Rebeca
author
Torres-Macho, Juan
author
Fernandez-Rodriguez, Amanda
author
Jimenez-Sousa, Maria Angeles
author
Jiménez, Eva
author
Pérez-Butragueño, Mario
author
Cuadros-González, Juan
author
Cadiñanos, Julen
author
García-García, Irene
author
Ryan, Pablo
author
Resino, Salvador
funder
Instituto de Salud Carlos III
2022-05-03T10:41:41Z
2022-05-03T10:41:41Z
2021
Front Med (Lausanne). 2021;8:736028.
10.3389/fmed.2021.736028
2296-858X
Frontiers in Medicine
34568391
http://hdl.handle.net/20.500.12105/14238
Background: Endothelial Activation and Stress Index (EASIX) predict death in patients undergoing allogeneic hematopoietic stem cell transplantation who develop endothelial complications. Because coronavirus disease 2019 (COVID-19) patients also have coagulopathy and endotheliitis, we aimed to assess whether EASIX predicts death within 28 days in hospitalized COVID-19 patients. Methods: We performed a retrospective study on COVID-19 patients from two different cohorts [derivation (n = 1,200 patients) and validation (n = 1,830 patients)]. The endpoint was death within 28 days. The main factors were EASIX [(lactate dehydrogenase * creatinine)/thrombocytes] and aEASIX-COVID (EASIX * age), which were log2-transformed for analysis. Results: Log2-EASIX and log2-aEASIX-COVID were independently associated with an increased risk of death in both cohorts (p < 0.001). Log2-aEASIX-COVID showed a good predictive performance for 28-day mortality both in the derivation cohort (area under the receiver-operating characteristic = 0.827) and in the validation cohort (area under the receiver-operating characteristic = 0.820), with better predictive performance than log2-EASIX (p < 0.001). For log2 aEASIX-COVID, patients with low/moderate risk (<6) had a 28-day mortality probability of 5.3% [95% confidence interval (95% CI) = 4-6.5%], high (6-7) of 17.2% (95% CI = 14.7-19.6%), and very high (>7) of 47.6% (95% CI = 44.2-50.9%). The cutoff of log2 aEASIX-COVID = 6 showed a positive predictive value of 31.7% and negative predictive value of 94.7%, and log2 aEASIX-COVID = 7 showed a positive predictive value of 47.6% and negative predictive value of 89.8%. Conclusion: Both EASIX and aEASIX-COVID were associated with death within 28 days in hospitalized COVID-19 patients. However, aEASIX-COVID had significantly better predictive performance than EASIX, particularly for discarding death. Thus, aEASIX-COVID could be a reliable predictor of death that could help to manage COVID-19 patients.
eng
COVID-19
Blood coagulation disorders
Clinical prediction rule
Endothelium
Mortality
Age-Adjusted Endothelial Activation and Stress Index for Coronavirus Disease 2019 at Admission Is a Reliable Predictor for 28-Day Mortality in Hospitalized Patients With Coronavirus Disease 2019
research article
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AgeAdjustedEndothelialActivation_2021.pdf
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AgeAdjustedEndothelialActivation_2021.pdf.txt