A New Early Predictor of Fatal Outcome for COVID-19 in an Italian Emergency Department: The Modified Quick-SOFA

Guarino, Matteo; Perna, Benedetta; Remelli, Francesca; Cuoghi, Francesca; Cesaro, Alice Eleonora; Spampinato, Michele Domenico; Maritati, Martina; Contini, Carlo; Giorgio, Roberto De

doi:10.3390/microorganisms10040806

Cited by 9 publications

(11 citation statements)

References 31 publications

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“…The summary of quality assessment using PROBAST is shown in Table 2. Overall, 13 retrospective cohort studies (23)(24)(25)(28)(29)(30)(31)(32)(33)(34)36,41,45) had a high risk of bias, principally because we assumed that subjects had systematic differences in the accuracy of reporting past information, resulting in recall bias (51,52). The details of the quality assessment are recorded in Appendix 2.…”

Section: Quality Assessmentmentioning

confidence: 99%

The accuracy of the National Early Warning Score 2 in predicting early death in prehospital and emergency department settings: a systematic review and meta-analysis

Wei¹,

Xiong²,

Wang³

et al. 2023

Ann Transl Med

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Background Many studies have explored the accuracy of the National Early Warning Score 2 (NEWS2) in predicting mortality in prehospital and emergency settings, but their findings are inconsistent. Whether NEWS2 is reliable for the pre-examination and triage of patients in prehospital settings and emergency departments remains debatable. Hence, this study aimed to evaluate the accuracy of NEWS2 in predicting mortality in prehospital settings and emergency departments. Methods We searched PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wan Fang Data, Vip Database and SinoMed from the inception of each database to January 2023. The inclusion criteria: (I) patients in the prehospital settings or emergency departments; (II) the NEWS2 for predicting 2-day mortality, 30-day mortality, and in-hospital mortality; (III) sufficient data, such as sensitivity, specificity, overall survival, and deaths, were provided for the study; (IV) the type of study was accuracy prediction study. Two authors independently extracted data, including authors, year of publication, country of origin, study design, sample size, threshold cutoff values of NEWS2, and mortality. The PROBAST was used to assess the risk of bias in the included studies. Results Thirty studies with 185,835 participants were included. Among the 30 included studies, 13 have a high risk of bias, and 17 have a low risk of bias. The pooled sensitivity, specificity and AUC of 2-day mortality (early mortality), 30-day mortality and in-hospital mortality were 0.81 vs. 0.76 vs. 0.72 (95% CI: 0.61, 0.80), 0.81 vs. 0.69 vs. 0.78 (95% CI: 0.49, 0.93) and 0.88 vs. 0.80 vs. 0.78 (95% CI: 0.74, 0.82), respectively. Conclusions NEWS2 has excellent sensitivity and specificity in predicting early mortality in patients in the prehospitals setting and emergency departments. Nonetheless, it has poor performance in predicting in-hospital mortality and 30-day mortality. Our findings underpin the use of NEWS2 as a pre-examination and triage tool to predict early death in the prehospital settings and emergency departments. To improve the predictive accuracy, it should be used to monitor patients continuously rather than at a single point-in-time.

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Section: Quality Assessmentmentioning

confidence: 99%

The accuracy of the National Early Warning Score 2 in predicting early death in prehospital and emergency department settings: a systematic review and meta-analysis

Wei¹,

Xiong²,

Wang³

et al. 2023

Ann Transl Med

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“…Of note, a recent study by Guarino et al mentioned new scale of ICU admission prognosis score named modified quick SOFA score (Mq‐SOFA) to evaluate in‐hospital survival for COVID‐19 cases in Italy. 33 They defined Mq‐SOFA based on four parameters: SpO2/FiO2 ratio, respiratory rate ≥22/min, systolic blood pressure ≤100 mmHg, and considerable disorientation or confusion. By doing so, they found that Mq‐SOFA could reliably predict both in‐hospital mortality and 30‐day mortality with high levels of sensitivity (58.1% and 84.2%, respectively), and diagnostic accuracy (78.3% and 77.6%, respectively).…”

Section: Discussionmentioning

confidence: 99%

“…Such risk factors should show high odds ratios in predicting mortality. Of note, a recent study by Guarino et al mentioned new scale of ICU admission prognosis score named modified quick SOFA score (Mq‐SOFA) to evaluate in‐hospital survival for COVID‐19 cases in Italy 33 . They defined Mq‐SOFA based on four parameters: SpO2/FiO2 ratio, respiratory rate ≥22/min, systolic blood pressure ≤100 mmHg, and considerable disorientation or confusion.…”

Section: Discussionmentioning

confidence: 99%

Serial SOFA‐score trends in ICU‐admitted COVID‐19 patients as predictor of 28‐day mortality: A prospective cohort study

Tarki

Afaghi

Rahimi

et al. 2023

Health Science Reports

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Background and Aim The efficacy of Sequential Organ Failure Assessment (SOFA) score as predictor of clinical outcomes among ICU‐admitted COVID‐19 patients is still controversial. We aimed to assess whether SOFA‐score in different time intervals could predict 28‐day mortality compared with other well‐acknowledged risk factors of COVID‐19 mortality. Methods This observational prospective cohort was conducted on 1057 patients from March 2020 to March 2022 at Masih Daneshvari Hospital, Iran. The univariate and multivariate Cox proportional analysis were performed to assess the hazards of SOFA‐score models. Receiver operating characteristic (ROC) curves were designed to estimate the predictive values. Results Mean SOFA‐score during first 96 h (HR: 3.82 [CI: 2.75–5.31]), highest SOFA‐score (HR: 2.70 [CI: 1.93–3.78]), and initial SOFA‐score (HR: 1.65 [CI: 1.30–2.11]) had strongest association with 28‐day mortality ( p < .0001). In contrast, SOFA scores at 48 and 96 h as well as Δ‐SOFA: 48‐0 h and Δ‐SOFA: 96‐0 h did not show significant correlations. Among them, merely mean SOFA‐score (HR: 2.28 [CI: 2.21–3.51]; p < .001) remained as independent prognosticator on multivariate regression analysis; though having less odds of predicting value compared with age (HR: 3.81 [CI: 1.98–5.21]), hypertension (HR: 3.11 [CI: 1.26–3.81]), coronary artery disease [CAD] (HR: 2.82 [CI: 1.51–4.8]), and diabetes mellitus (HR: 2.45 [CI: 1.36–2.99]). The area under ROC (AUROC) for mean SOFA‐score (0.77) and highest SOFA‐score (0.71) were larger than other SOFA intervals. Calculating the first 96 h of SOFA trends, it was obtained that fatality rate was <12.3% if the score dropped, between 28.8% and 46.29% if the score remained unchanged, and >50.45% if the score increased. Conclusion To predict the 28‐day mortality among ICU‐admitted COVID‐19 patients, mean SOFA upon first 96 h of ICU stay is reliable; while having inadequate accuracy comparing with well‐acknowledged COVID‐19 mortality predictors (age, diabetes mellitus, hypertension, CAD). Notably, increased SOFA levels in the course of first 96 h of ICU‐admission, prognosticate at least 50% fatality regardless of initial SOFA score.

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“…Coronavirus Disease 2019 (COVID-19) is a life-threatening disease caused by the SARS-CoV-2 virus, and it was firstly reported in China and then spread worldwide [1]. Since the beginning of the COVID-19 pandemic, millions of patients have died because of complicated SARS-CoV-2 pneumonia [1][2][3]. The clinical features of COVID-19 range from an asymptomatic condition to severe/fatal lung injury and multi-organ failure.…”

Section: Introductionmentioning

confidence: 99%

“…The clinical features of COVID-19 range from an asymptomatic condition to severe/fatal lung injury and multi-organ failure. Common complications include acute respiratory distress syndrome (ARDS), acute kidney and liver dysfunctions, delirium/encephalopathy, thrombosis, and cardiac damage (e.g., cardiomyopathy, arrhythmias, and sudden cardiac death) [1,2]. The severity of this condition suggested that pulmonary co-infections (e.g., Chlamydia pneumoniae, Mycoplasma pneumoniae, pneumococcus, or other agents, e.g., viruses) might have a role in worsening clinical manifestations of SARS-CoV-2 pneumonia [4].…”

Section: Introductionmentioning

confidence: 99%

Role of Intracellular Pulmonary Pathogens during SARS-CoV-2 Infection in the First Pandemic Wave of COVID-19: Clinical and Prognostic Significance in a Case Series of 1200 Patients

et al. 2022

Self Cite

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Background: Since 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic (COVID-19) has caused millions of deaths worldwide and is the second most serious pandemic after the Spanish flu. Despite SARS-CoV-2 infection having a dominant effect on morbidity and life-threatening outcomes, the role of bacterial co-infection in patients with COVID-19 is poorly understood. The present study aimed to verify the existence of bacterial co-infections and their possible role as cofactors worsening COVID-19-related clinical manifestations. Methods: All patients with suspected SARS-CoV-infection, hospitalised in COVID-19 wards at the Sant’Anna University Hospital of Ferrara, were retrospectively included in this single-centre study and their specific bacterial serologies were assessed. Univariate and logistic regression analyses were performed. Results: A total of 1204 individual records were retrieved. Among them, 959 were excluded because of a negative nasopharyngeal swab or missing data; of the eligible 245 patients, 51 were co-infected. Compared to patients with SARS-CoV-2 infection alone, those with Chlamydia pneumoniae or Mycoplasma pneumoniae co-infections had worse respiratory/radiological features and more intensive care unit admissions. However, the co-infection did not result in a higher mortality rate. Conclusions: The present study, comparing clinical, laboratory and radiological findings between patients with COVID-19 vs. those with co-infections (C. pneumoniae or M. pneumoniae) showed that, on admission, these features were worse in co-infected patients, although the mortality rate did not differ between the two groups.

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A New Early Predictor of Fatal Outcome for COVID-19 in an Italian Emergency Department: The Modified Quick-SOFA

Cited by 9 publications

References 31 publications

The accuracy of the National Early Warning Score 2 in predicting early death in prehospital and emergency department settings: a systematic review and meta-analysis

The accuracy of the National Early Warning Score 2 in predicting early death in prehospital and emergency department settings: a systematic review and meta-analysis

Serial SOFA‐score trends in ICU‐admitted COVID‐19 patients as predictor of 28‐day mortality: A prospective cohort study

Role of Intracellular Pulmonary Pathogens during SARS-CoV-2 Infection in the First Pandemic Wave of COVID-19: Clinical and Prognostic Significance in a Case Series of 1200 Patients

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