Abstract
Background: Severity scores in pneumonia and sepsis are being applied to SARS-CoV-2 infection. We aimed to assess whether these severity scores are accurate predictors of early adverse outcomes in COVID-19.
Methods: We conducted a multicentre observational study of hospitalised SARS-CoV-2 infection. We assessed risk scores (CURB65, qSOFA, Lac-CURB65, MuLBSTA and NEWS2) in relation to admission to intensive care or death within 7 days of admission, defined as early severe adverse events (ESAE). The 4C Mortality Score was also assessed in a sub-cohort of patients.
Findings: In 2,387 participants, the overall mortality was 18%. In all scores examined, increasing score was associated with increased risk of ESAE. Area under the curve (AUC) to predict ESAE for CURB65, qSOFA, Lac-CURB65, MuLBSTA and NEWS2 were 0.61, 0.62, 0.59, 0.59 and 0.68, respectively. AUC to predict ESAE was 0.60 with ISARIC 4C Mortality Score.
Conclusion: None of the scores examined accurately predicted ESAE in SARS-CoV-2 infection. Non-validated scores should not be used to inform clinical decision making in COVID-19.
Keywords: COVID-19; collaborative; pneumonia; severity score.
【저자키워드】 COVID-19, Pneumonia, Severity score., collaborative, 【초록키워드】 intensive care, SARS-COV-2 infection, severity, Sepsis, adverse outcome, Severity Score, death, multicentre, predictor, Admission, patients, predict, score, AUC, risk score, qSOFA, NEWS2, Participants, overall mortality, increased risk, 4C mortality score, clinical decision, hospitalised, defined, predicted, examined, conducted, applied, Area, CURB65, ISARIC 4C, severe adverse event, sub-cohort, 【제목키워드】 severity, multicentre,