Endothelial Activity and Stress Index (EASIX) Score as a Predictor for Early Severe COVID-Related Mortality

Elrefy, Mahmoud Ahmed; Shoeib, Sabry; AboZenah, Ahmed; Kassab, Ibrahim; Efat, Alaa

doi:10.21608/ejhm.2025.415726.1824

Endothelial Activity and Stress Index (EASIX) Score as a Predictor for Early Severe COVID-Related Mortality

Document Type : Original Article

Authors

¹ Lecturer of Internal Medicine & Hematology / faculty of Medicine / Menoufia University

² Hematology Unit, Department Of Internal Medicine, faculty of Medicine, Menoufia University, Shebin Al Kom, Egypt

³ physician at cairo university hospitals, Egypt

⁴ Department Of Internal Medicine , Sirs Allyan General Hospital , Menoufia , Egypt

10.21608/ejhm.2025.415726.1824

Abstract

Background: Severe COVID-19 often triggers an uncontrolled surge of pro-inflammatory cytokines, leading to endothelial injury that plays a critical role in early mortality.
Objective: This study aimed to estimate endothelial activity and stress index (EASIX) score and find out if there is association between EASIX score and early mortality in adults with severe COVID-19.
Subjects and methods: This retrospective observational analysis study included 200 adult patients diagnosed with severe COVID-19 and admitted to Menoufia University Hospitals between June and November 2021. Patients were divided into two groups: survivors and non-survivors.
Results: EASIX scores were significantly higher in non-survivors indicating a strong association with early COVID-19–related deaths. Significant differences were also noted between the two groups in hemoglobin levels, absolute lymphocyte count, D-dimer, LDH, CRP, ferritin, creatinine, and BUN values.
Conclusion: The EASIX score demonstrated excellent predictive accuracy for early mortality (AUC = 0.981) and can serve as a practical tool for assessing risk in severe COVID-19 patients.

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