qSOFA score poorly predicts critical progression in COVID-19 patients

Abstract

Summary Background In December 2019, the new virus infection coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged. Simple clinical risk scores may improve the management of COVID-19 patients. Therefore, the aim of this pilot study was to evaluate the quick Sequential Organ Failure Assessment (qSOFA) score, which is well established for other diseases, as an early risk assessment tool predicting a severe course of COVID-19. Methods We retrospectively analyzed data from adult COVID-19 patients hospitalized between March and July 2020. A critical disease progress was defined as admission to intensive care unit (ICU) or death. Results Of 64 COVID-19 patients, 33% (21/64) had a critical disease progression from which 13 patients had to be transferred to ICU. The COVID-19-associated mortality rate was 20%, increasing to 39% after ICU admission. All patients without a critical progress had a qSOFA score ≤ 1 at admission. Patients with a critical progress had in only 14% (3/21) and in 20% (3/15) of cases a qSOFA score ≥ 2 at admission (p = 0.023) or when measured directly before critical progression, respectively, while 95% (20/21) of patients with critical progress had an impairment oxygen saturation (SO2) at admission time requiring oxygen supplementation. Conclusion A low qSOFA score cannot be used to assume short-term stable or noncritical disease status in COVID-19.

Comparison of prognostic scores for inpatients with COVID-19: a retrospective monocentric cohort study

“…In agreement with our analysis, most studies report poor performance of the qSOFA as a mortality prediction tool11 38–45 and as an ICU-admission predictor25 32 43–46 for patients with COVID-19. This may be explained by the fact that, in contrast with bacterial CAP, circulatory failure occurs seldomly in patients with COVID-19, and outcomes are mainly determined by the severity of AHRF, age and comorbid conditions which are poorly taken into account in qSOFA.…”

Brixia and qSOFA Scores, Coagulation Factors and Blood Values in Spring versus Autumn 2021 Infection in Pregnant Critical COVID-19 Patients: A Preliminary Study

“…However, neither Brixia score nor qSOFA score in one particular day could predict the radiological or clinical evolution of the patient during the next days, in either spring or autumn patients. This is in accordance with Cagino [ 52 ], Heldt [ 53 ] and Alencar [ 54 ], who found no correlation between qSOFA score and outcomes in pregnant or nonpregnant COVID-19 patients. Still, Aashik [ 55 ] found the qSOFA score to predict the mortality of COVID-19 patients, while Vikas [ 56 ] found the Brixia A score and qSOFA score to predict outcomes in severe forms of pregnant COVID-19 patients.…”

Comparison of different prognostic scores in estimating short- and long-term mortality in COVID-19 patients above 60 years old in a university hospital in Belgium

“…Although these scores have proven their value in detecting acute deterioration in COVID-19 patients [34], we could not confirm a better estimation of mortality in our population. qSOFA is a mortality score in patients with suspected sepsis but has already been proven a poor indicator in estimating mortality in COVID-19 patients [35,36], possibly because of the limited number of parameters included and not taking into account oxygen saturation [37].…”