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Objective To analyze various clinical scores and to understand which of these are able to predict mortality and clinical worsening in patients with Covid-19 disease admitted to an ED. Material and methods The research question was: What are the best clinical scores used to predict hospital mortality or worsening of clinical conditions with hospitalization in intensive care in adult patients with Covid-19 who present in ED? The research of the articles and the consequent review of the literature were performed using databases such as Pubmed, Cochrane Database of Systematic Re-view and CINAHL Database (Cumulative Index to Nursing and Allied Health Literature) until November 4, 2021. The keywords used were clinical scores, risk stratifications, Covid patients and Emergency Department. Inclusion criteria were patients > 18 years with symptoms and diagnosed Covid-19 disease admitted to the ED or directly to the hospital, prospective and retrospective cohort studies, randomized studies, meta-analyses, use or analysis of a clinical score and articles published in English between January 2020 and August 2021 without countries restrictions. Exclusion criteria were unpublished articles, articles without abstracts, articles with a population different from the selected one, articles with outcomes different from those selected and articles that did not mention or did not analyze the effectiveness of a score or a scale. The studies selected compared NEWS, NEWS2, SIRS, q-SOFA, CURB-65, PSI, REMS, MEWS, RISE UP, 4C MORTALITY SCORE, TRPNCLP and STPCAL scores for patients with confirmed Covid-19 disease admitted to Emergency Department. A meta-analysis was carried out by using fixed effects and random effects models to evaluate mortality and Intensive Care Unit (ICU) admission in patients presenting in ED. Results A total of 39318 patients from 8 studies, 5 retrospective observational and 3 prospective, were included. Likelihood ratio was 9.1 (95% CI, 4.76-17.5) for NEWS and 3.3 (95% CI, 2.5-4.3) for NEWS2 in two different studies. The Area Under the Curve values were regarding to intensive care unit admission 0.94 (95% CI, 0.88-0.99) and 0.8 (95% CI, 0.72-0.8) for NEWS and NEWS2 respectively. Considering mortality AUC values were 0.87 (95% CI, 0.72-1.00) and 0.8 (95% CI, 0.72-0.88) for NEWS and NEWS2 respectively. q-SOFA is probably the second most reliable score, analyzed and studied by most of the articles and in one study AUC value was 0.78 (95% CI, 0.60-0.96) for mortality and 0.78 (95% CI, 0.64-0.93) for ICU admission. Considering the scores created and studied specifically for Covid-19 disease the most accurate is the TRPNCLP score with a AUC value of 0.88 (95% CI, 0.85-0.91) and an LR + of 4.86 (95% CI, 4.01-5.88). Also RISE UP score and 4C mortality score had excellent results with a positive LR +> 1 and AUC values very close to the 0.80. Conclusions The clinical scores that are more reliable in predicting hospital mortality and admission to intensive care units are NEWS and NEWS2. At the beginning Covid-19 disease management is based on home monitoring so that the use of clinical scores NEWS and NEWS2 could be an effective to predict mortality and worsening of clinical conditions.