Background We retrospectively data-mined the case records of Reverse Transcription Polymerase Chain Reaction (RT-PCR) confirmed COVID-19 patients hospitalized to a tertiary care centre to derive mortality predictors and formulate a risk score, for prioritizing admission. Methods and findings Data on clinical manifestations, comorbidities, vital signs, and basic lab investigations collected as part of routine medical management at admission to a COVID-19 tertiary care centre in Chengalpattu, South India between May and November 2020 were retrospectively analysed to ascertain predictors of mortality in the univariate analysis using their relative difference in distribution among ‘survivors’ and ‘non-survivors’. The regression coefficients of those factors remaining significant in the multivariable logistic regression were utilised for risk score formulation and validated in 1000 bootstrap datasets. Among 746 COVID-19 patients hospitalised [487 “survivors” and 259 “non-survivors” (deaths)], there was a slight male predilection [62.5%, (466/746)], with a higher mortality rate observed among 40–70 years age group [59.1%, (441/746)] and highest among diabetic patients with elevated urea levels [65.4% (68/104)]. The adjusted odds ratios of factors [OR (95% CI)] significant in the multivariable logistic regression were SaO 2 <95%; 2.96 (1.71–5.18), Urea ≥50 mg/dl: 4.51 (2.59–7.97), Neutrophil-lymphocytic ratio (NLR) >3; 3.01 (1.61–5.83), Age ≥50 years;2.52 (1.45–4.43), Pulse Rate ≥100/min: 2.02 (1.19–3.47) and coexisting Diabetes Mellitus; 1.73 (1.02–2.95) with hypertension and gender not retaining their significance. The individual risk scores for Sa O 2 <95–11, U rea ≥50 mg/dl-15, NL R >3–11, A ge ≥50 years-9, Pulse R ate ≥100/min-7 and coexisting d iabetes mellitus-6, acronymed collectively as ‘ OUR-ARDs score ’ showed that the sum of scores ≥ 25 predicted mortality with a sensitivity-90%, specificity-64% and AUC of 0.85. Conclusions The ‘OUR ARDs’ risk score, derived from easily assessable factors predicting mortality, offered a tangible solution for prioritizing admission to COVID-19 tertiary care centre, that enhanced patient care but without unduly straining the health system.
【초록키워드】 COVID-19, Hospitalized, Mortality, Comorbidities, Gender, risk, RT-PCR, hypertension, clinical manifestations, management, male, age, vital signs, mortality rate, predictor, health system, distribution, Admission, Care, NLR, COVID-19 patient, AUC, risk score, urea, south India, Patient care, Factor, adjusted odds ratio, reaction, chain, multivariable logistic regression, coefficient, Univariate analysis, datasets, bootstrap, hospitalised, lab, diabetic patient, highest, predicted, collected, Rate, elevated, analysed, utilised, offered, 【제목키워드】 Mortality, risk, hospitalized COVID-19 patient, south India,