External validation of 4C ISARIC mortality score in the setting of a Saudi Arabian ICU. Retrospective study

Mumtaz, Shahzad; Shahzad, Saima A.; Ahmed, Intekhab; Alodat, Mohammed; Gharba, Mohamed; Saif, Zohdy A.; Mady, Ahmed; Mahmood, Waqas; Mhawish, Huda; Abdulmowla, Majd M.; Aletreby, Waleed Tharwat

doi:10.1101/2021.08.16.21262104

Cited by 2 publications

(2 citation statements)

References 17 publications

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“…However; previous publications highlighted that death of COVID-19 patients usually is not a direct result of the viral infection itself, but rather due to the complications that accompany the infection, such as Acute Respiratory Distress Syndrome (ARDS) following a cytokine storm, super-added infections, multi-organ failure, and septic shock 25 , which most probably would be the case in severe presentations of the disease. This can be observed in our results as a younger age, closer to normal INR and BUN of survivors, in addition to the association of those parameter with mortality in the logistic regression model, since age of the patient is definitely a contributing factor in the severity of the presentation, to the extent that it is incorporated in mortality risk prediction models 26 , and disturbed physiological parameters also indicate a more severe presentation.…”

Section: Discussionsupporting

confidence: 71%

Favipiravir Efficacy and Safety for the Treatment of Severe Coronavirus 2019. A Retrospective Study.

Abdulrahman¹,

Mady

Odat

et al. 2022

J Ayub Med Coll Abbottabad

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Background: Corona virus disease is caused by the enveloped, single stranded RNA virus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) becoming the deadliest disease of the century. Its global outbreak has led researchers to develop drugs or vaccines to prevent the spread of the disease. Favipiravir is an approved orally administered antiviral drug that selectively inhibits RNA-dependent RNA polymerase, used off-label to treat COVID-19. Objectives: The purpose of this study was to assess the efficacy and safety of this drug for severe COVID-19 infection. Methods: This was an observational retrospective study, carried out at the ICU of King Saud Medical City (KSMC) from June 2020 to August 2020. Including a total of one thousand six hundred and ninety-nine patients (n=1699). Categorized into a treatment group (193 patients) who received Favipiravir along with standard care, and non-treatment group (1506 patients) who received standard care only. Results: ICU all-cause mortality was similar in both groups i.e., (Treated group 38.3% Vs Untreated group 39.4%, 95% CI of difference: -6.6% to +8.4%; p = 0.8). The subgroup analysis of survivors as compared to deceased in the treatment group showed that survivors had significantly lower age, international normalising ratio (INR), blood urea nitrogen (BUN), and creatinine. The mean ICU length of stay (LOS) was shorter for survivors compared to deceased (11.2± 8.03 Vs 16.7±9.8 days respectively), while hospital LOS was almost similar between the two groups. Advanced age (OR 1.03 [95% CI: 1.01–1.06]; p=0.004), higher INR and BUN were significantly associated with increased odds of mortality. Comparison of lab investigations at day 1 and day 10 in the treatment group (regardless of outcome) showed that there was a significant increase in Alanine transaminase (ALT), alkaline phosphatase (ALK), and Bilirubin, while an insignificant trend of increase in Aspartate transaminase (AST) and creatinine was recorded. Conclusion: In this study, Favipiravir showed better therapeutic responses in patients with severe COVID-19 infection, in terms of average duration of stay in the intensive care unit and was well tolerated in the younger age, but showed no mortality benefit. However, elevated levels of inflammatory markers, including increased ALT, AST, BUN, bilirubin, and creatinine, needs to be carefully examined.

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Section: Discussionsupporting

confidence: 71%

Favipiravir Efficacy and Safety for the Treatment of Severe Coronavirus 2019. A Retrospective Study.

Abdulrahman¹,

Mady

Odat

et al. 2022

J Ayub Med Coll Abbottabad

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“…The scores used for such comparisons were chosen based on two conditions: (1) they had already been evaluated for COVID-19 in other studies, and (2) they used parameters that were available within our database, with accessible methods for calculation (described in a previous publication). They are SOFA ( 15 ), SAPS-3 ( 16 , 17 ), NEWS2 ( 18 ), 4C Mortality Score ( 19 , 20 ), SOARS ( 21 ), CURB-65 ( 22 ), and a novel severity score developed by Altschul et al ( 23 ). A modified version of the CHA2DS2-VASc score tested in a previous publication to assess mortality in ICU COVID-19 patients (scoring for male sex instead of female) was included in the comparison as well ( 24 ).…”

Section: Methodsmentioning

confidence: 99%

Assessment of risk scores to predict mortality of COVID-19 patients admitted to the intensive care unit

et al. 2023

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ObjectivesTo assess the ABC2-SPH score in predicting COVID-19 in-hospital mortality, during intensive care unit (ICU) admission, and to compare its performance with other scores (SOFA, SAPS-3, NEWS2, 4C Mortality Score, SOARS, CURB-65, modified CHA2DS2-VASc, and a novel severity score).Materials and methodsConsecutive patients (≥ 18 years) with laboratory-confirmed COVID-19 admitted to ICUs of 25 hospitals, located in 17 Brazilian cities, from October 2020 to March 2022, were included. Overall performance of the scores was evaluated using the Brier score. ABC2-SPH was used as the reference score, and comparisons between ABC2-SPH and the other scores were performed by using the Bonferroni method of correction. The primary outcome was in-hospital mortality.ResultsABC2-SPH had an area under the curve of 0.716 (95% CI 0.693–0.738), significantly higher than CURB-65, SOFA, NEWS2, SOARS, and modified CHA2DS2-VASc scores. There was no statistically significant difference between ABC2-SPH and SAPS-3, 4C Mortality Score, and the novel severity score.ConclusionABC2-SPH was superior to other risk scores, but it still did not demonstrate an excellent predictive ability for mortality in critically ill COVID-19 patients. Our results indicate the need to develop a new score, for this subset of patients.

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External validation of 4C ISARIC mortality score in the setting of a Saudi Arabian ICU. Retrospective study

Cited by 2 publications

References 17 publications

Favipiravir Efficacy and Safety for the Treatment of Severe Coronavirus 2019. A Retrospective Study.

Favipiravir Efficacy and Safety for the Treatment of Severe Coronavirus 2019. A Retrospective Study.

Assessment of risk scores to predict mortality of COVID-19 patients admitted to the intensive care unit

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