Evaluation of Clinical Predictors for Major Outcomes in Patients Hospitalized With COVID-19: The Potential Role of the Rothman Index

Moguillansky, Diego; Sharaf, Omar M.; Jin, Phoebe; Samra, Ronny; Bryan, J. Shepard; Moguillansky, Natalia; Lascano, Jorge; Kattan, Juan N

doi:10.7759/cureus.28769

Cited by 1 publication

(2 citation statements)

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“…This model achieved a high level of accuracy for both training (AUC 96–99) and testing (AUC 84 to 85) for predicting in-hospital mortality, providing a helpful prognostic tool for clinicians who may take early interventions to avert potentially fatal outcomes. Our model is in agreement with recent publications documenting the value of both the NEWS2 score (AUC 74) [ 36 ] and Rothman Index (AUC 81 to 84) [ 37 , 38 ] for predicting in-hospital mortality in COVID-19 infection.…”

Section: Discussionsupporting

confidence: 91%

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Comparison of the clinical characteristics of SARS-CoV-2 Delta (B.1.617.2) and Omicron (B.1.1.529) infected patients from a single hospitalist service

Radhakrishnan,

Liu,

Idowu

et al. 2023

BMC Infect Dis

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Background While existing evidence suggests less severe clinical manifestations and lower mortality are associated with the Omicron variant as compared to the Delta variant. However, these studies fail to control for differences in health systems facilities and providers. By comparing patients hospitalized on a single medical service during the Delta and Omicron surges we were able to conduct a more accurate comparison of the two varaints’ clinical manifestations and outcomes. Methods We conducted a prospective study of 364 Omicron (BA.1) infected patients on a single hospitalist service and compared these findings to a retrospective analysis of 241 Delta variant infected patients managed on the same service. We examined differences in symptoms, laboratory measures, and clinical severity between the two variants and assessed potential risk drivers for case mortality. Findings Patients infected with Omicron were older and had more underlying medical conditions increasing their risk of death. Although they were less severely ill and required less supplemental oxygen and dexamethasone, in-hospital mortality was similar to Delta cases, 7.14% vs. 4.98% for Delta (q-value = 0.38). Patients older than 60 years or with immunocompromised conditions had much higher risk of death during hospitalization, with estimated odds ratios of 17.46 (95% CI: 5.05, 110.51) and 2.80 (1.03, 7.08) respectively. Neither vaccine history nor variant type played a significant role in case fatality. The Rothman score, NEWS-2 score, level of neutrophils, level of care, age, and creatinine level at admission were highly predictive of in-hospital death. Interpretation In hospitalized patients, the Omicron variant is less virulent than the Delta variant but is associated with a comparable mortality. Clinical and laboratory features at admission are informative about the risk of death.

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Section: Discussionsupporting

confidence: 91%

“…1 C). This score objectively documented the weakened medical condition of fatal Omicron-infected patients at the time of admission and warned of a poor prognosis [ 37 , 38 ].…”

Section: Discussionmentioning

confidence: 99%