Predictive performance of SOFA and qSOFA for in-hospital mortality in severe novel coronavirus disease

Abstract

Objectives The assessment of illness severity at admission can contribute to decreased mortality in patients with the coronavirus disease (COVID-19). This study was conducted to evaluate the effectiveness of the Sequential Organ Failure Assessment (SOFA) and Quick Sequential Organ Failure Assessment (qSOFA) scoring systems at admission for the prediction of mortality risk in COVID-19 patients. Methods We included 140 critically ill COVID-19 patients. Data on demographics, clinical characteristics, and laboratory findings at admission were used to calculate SOFA and qSOFA against the in-hospital outcomes (survival or death) that were ascertained from the medical records. The predictive accuracy of both scoring systems was evaluated by the receiver operating characteristic (ROC) curve analysis. Results The area under the ROC curve for SOFA in predicting mortality was 0.890 (95% CI: 0.826–0.955), which was higher than that of qSOFA (0.742, 95% CI 0.657–0.816). An optimal cutoff of ≥3 for SOFA had sensitivity, specificity, positive predictive value, and negative predictive value of 90.00%, 83.18%, 50.00%, and 97.80%, respectively. Conclusions This novel report indicates that SOFA could function as an effective adjunctive risk-stratification tool at admission for critical COVID-19 patients. The performance of qSOFA is accepted but inferior to that of SOFA.

Determinants of in-hospital mortality in COVID-19; a prospective cohort study from Pakistan

“…Unit increase in SOFA score was associated with high odds of mortality in our data. Since SOFA tends to reflect the effect on multiple organ systems, it has proved to be a better predictor of mortality in COVID-19 [24]. Some desperate therapies used globally including Hydroxychloroquine and azithromycin (alone or in combination), therapeutic anticoagulation, antibiotics, two doses of Tocilizumab and IVIG showed increased odds of mortality which when adjusted for other factors became insignificant in the final model.…”

Clinical and Virological Characteristics of Hospitalized COVID-19 Patients in a German Tertiary Care Center during the First Wave of the SARS-CoV-2 Pandemic

“…Host factors predictive of severe clinical course and adverse outcome in patients with Coronavirus disease 2019 (COVID-19) include older age, male gender, and preexisting chronic comorbidities [1][2][3][4][5][6]. Several risk scores containing clinical characteristics, laboratory assessments, and biomarkers have been proposed for improved patient management and resource allocation [5,7] .…”

Clinical features of pregnant women in Iran who died due to COVID‐19

“…Furthermore, the rate of mortality may increase two-to tenfold among patients admitted to the intensive care unit (ICU) with pre-existing morbidities such as cardiovascular disease and diabetes [1,3]. Li et al [3] reported that the mortality rate of patients with hypertension, cerebrovascular diseases, and diabetes was two-, three-, and twofold higher in patients admitted to the ICU, respectively. The main risk factors of mortality are older age, shortness of breath or dyspnea, low level of hemoglobin, and underlying comorbidities.…”