Predictive value of National Early Warning Score 2 (NEWS2) for intensive care unit admission in patients with SARS-CoV-2 infection

Abstract

Background: From January 2020, Coronavirus disease 19 (COVID-19) has rapidly spread all over the world. An early assessment of illness severity is important for the stratification of patients. We analysed the predictive value of National Early Warning Score 2 (NEWS2) for intensive care unit admission (ICU) in patients with Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) infection.

The performance of the National Early Warning Score and National Early Warning Score 2 in hospitalised patients infected by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)

“…Gidari et al showed that the predictive value of admission NEWS2 values for ICU admission in 68 patients with severe COVID-19 was good (AUROC = 0.90 (CI, 0.82–0.97)). 33 Peng et al showed similar AUROC values for predicting ‘serious events’ of 0.837 (0.748−0.943) for admission NEWS and 0.846 (0.735−0.939) for admission NEWS modified by age, where ‘serious events’ were defined as any of the following during hospitalisation: death, unplanned transfer to an ICU or initiation of non-invasive ventilation. 34 Covino et al reported that NEWS was the most accurate predictor of ICU admission within 48 h (AUROC = 0.802 (0.756−0.844)) and 7 days (AUROC 0.783 (0.735−0.826)) of emergency department arrival.…”

“…Our study provides data from a large cohort of unselected hospital admissions and focuses on an outcome measure that is both clinically relevant and has the potential to be averted with the appropriate and timely clinical intervention. Unlike other journal publications, 33 , 34 , 35 , 36 , 37 it uses NEWS and NEWS2 values from the whole hospital admission and compares the performance of the scores in patients who had a positive RT-PCR test result for SARS-CoV-2 with several other patient groups in the same hospital that were, as far as can be determined, not suffering from a COVID-19 illness. This has permitted an assessment of the need for any amendment to NEWS or NEWS2, such as the addition of age 34 , 38 or other covariates or a change in the weighting of existing parameters, 39 when evaluating patients with COVID-19.…”

The usefulness of NEWS2 at day 7 of hospitalization in predicting COVID-19 evolution and as an early endpoint in therapeutic trials

“…1 However, NEWS2 has been described as a robust tool to predict outcome during sepsis 2 and seems to predict evolution of COVID-19 upon admission to the hospital in other recently studies. [3][4][5] Considering the evolution of the epidemic, there is a need for reliable tools to predict some evolution in particular with regard to hospitalized patients, in order to discharge more quickly the patients from medical wards to home.…”

Use of the first National Early Warning Score recorded within 24 hours of admission to estimate the risk of in-hospital mortality in unplanned COVID-19 patients: a retrospective cohort study

“…A higher NEWS2 correlates with a higher chance of deterioration. Gidari et al 6 evaluated NEWS2 at hospital admission of patients with COVID-19 as a predictor of intensive care unit (ICU) admission. Furthermore, Kostakis et al 7 investigated association of the last or ultimate recorded NEWS2/NEWS within 24 hours of death or ICU admission in COVID-19 and non-COVID cohorts.…”