Abstract
Background/objectives: Several scoring systems have been specifically developed for risk stratification in COVID-19 patients.
Design: We compared, in a cohort of confirmed COVID-19 older patients, three specifically developed scores with a previously established early warning score. Main endpoint was all causes in-hospital death.
Setting: This is a single-center, retrospective observational study, conducted in the Emergency Department (ED) of an urban teaching hospital, referral center for COVID-19.
Participants: We reviewed the clinical records of the confirmed COVID-19 patients aged 60 years or more consecutively admitted to our ED over a 6-week period (March 1st to April 15th, 2020). A total of 210 patients, aged between 60 and 98 years were included in the study cohort.
Measurements: International Severe Acute Respiratory Infection Consortium Clinical Characterization Protocol-Coronavirus Clinical Characterization Consortium (ISARIC-4C) score, COVID-GRAM Critical Illness Risk Score (COVID-GRAM), quick COVID-19 Severity Index (qCSI), National Early Warning Score (NEWS).
Results: Median age was 74 (67-82) and 133 (63.3%) were males. Globally, 42 patients (20.0%) deceased. All the score evaluated showed a fairly good predictive value with respect to in-hospital death. The ISARIC-4C score had the highest area under ROC curve (AUROC) 0.799 (0.738-0.851), followed by the COVID-GRAM 0.785 (0.723-0.838), NEWS 0.764 (0.700-0.819), and qCSI 0.749 (0.685-0.806). However, these differences were not statistical significant.
Conclusion: Among the evaluated scores, the ISARIC-4C and the COVID-GRAM, calculated at ED admission, had the best performance, although the qCSI had similar efficacy by evaluating only three items. However, the NEWS, already widely validated in clinical practice, had a similar performance and could be appropriate for older patients with COVID-19.
Keywords: COVID-19; COVID-GRAM; ISARIC-4C; NEWS; qCSI.
【저자키워드】 COVID-19, NEWS, COVID-GRAM, ISARIC-4C, qCSI., 【초록키워드】 Efficacy, hospital, risk stratification, Cohort, older patient, clinical, Patient, age, respiratory, Admission, patients, score, COVID-19 patients, Clinical practice, Early warning score, retrospective, Emergency, Deceased, older patients, COVID-19 patient, ROC Curve, Predictive, In-hospital death, characterization, scoring system, index, Endpoint, single-center, AUROC, Department, study cohort, males, statistical, highest, evaluated, conducted, calculated, cause, illness, with COVID-19, 【제목키워드】 score, Developed,