Utility of severity assessment tools in COVID-19 pneumonia: a multicentre observational study

Asim Ahmed, Sayed A Alderazi, Rumaisa Aslam, Barooq Barkat, Bethan L Barker, Rahul Bhat, Samuel Cassidy, Louise E Crowley, Davinder Ps Dosanjh, Hussain Ebrahim, Najla Elndari, Claudia Gardiner, Atena Gogokhia, Frances S Grudzinska, Megha T Gurung, Terry Hughes, Iyad Ismail, Natasha Iredale, Sannaan Irshad, Sarah JohnsonDiana Kavanagh, Thomas Knight, Alana Livesey, Sebastian T Lugg, Manoj Marathe, Andrew Mcdougall, Wasim Nawaz, Kimberly Nettleton, Lauren O’flynn, Kelvin Okoth, Dhruv Parekh, Rita Perry, Elizabeth J Pudney, Ambreen Sadiq, Olutobi Soge, Rhania Soloman, Marina Soltan, Martin Strecker, Onn S Thein, David Thickett, Ajit Thomas, Riah Thornton

Research output: Contribution to journalArticlepeer-review

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.
Original languageEnglish
Pages (from-to)63-70
Number of pages8
JournalClinical Medicine
Volume22
Issue number1
DOIs
Publication statusPublished - 25 Jan 2022

Keywords

  • COVID-19
  • pneumonia
  • severity score
  • collaborative

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