Stratification of patients admitted for SARS-CoV2 infection: prognostic scores in the first and second wave of the pandemic

Abstract

To test the prognostic performance of different scores, both specifically designed for patients with COVID-19 and generic, in predicting in-hospital mortality and the need for mechanical ventilation (MV). We retrospectively collected clinical data of patients admitted to the Emergency Department of the University Hospital AOU Careggi, Florence, Italy, between February 2020 and January 2021, with a confirmed infection by SARS-CoV2. We calculated the following scores: Sequential Organ Failure Assessment (SOFA) score, CALL score, 4C Mortality score, QUICK score, CURB-65 and MuLBSTA score. The end-points were in-hospital mortality and the need for MV. We included 1208 patients, mean age 60 ± 17 years, 57% male sex. Compared to survivors, non-survivors showed significantly higher values of all the prognostic scores (4C: 13 [10–15] vs 8 [4–10]; CALL: 11 [10–12] vs 9 [7–11]; QUICK: 4 [1–6] vs 0 [0–3]; SOFA: 5 [4–6] vs 4 [4–5]; CURB: 2 [1–3] vs 1 [0–1]; MuLBSTA: 11 [9–13] vs 9 [7–11], all p < 0.001). Discriminative ability evaluated by the Receiver Operating Curve analysis showed the following values of the Area under the Curve: 0.83 for 4C, 0.74 for CALL, 0.70 for QUICK, 0.68 for SOFA, 0.76 for CURB and 0.64 for MuLBSTA. The mortality rate significantly increased in increasing quartiles of 4C and CALL score (respectively, 2, 8, 24 and 54% for the 4C score and 1, 17, 33 and 68% for the CALL score, both p < 0.001). 4C and CALL score allowed an early and good prognostic stratification of patients admitted for pneumonia induced by SARS-CoV2.

Performance of CURB-65 and ISARIC 4C mortality scores for hospitalized patients with confirmed COVID-19 infection in Saudi Arabia

“…However, our cohort includes patients infected during the first and second COVID-19 pandemic waves. It reveals good ISARIC 4C mortality score performance, which is in agreement with the conclusion of Innocenti et al study [ 37 ].…”

Circulating mid-regional proadrenomedullin is a predictor of mortality in patients with COVID-19: a systematic review and meta-analysis

“…The study population we included had different severities of illness, and the overall mortality rate was 19%. Many studies have used various biomarkers, such as CRP [ 39 – 44 ], PCT [ 39 , 43 , 45 , 46 ], IL-6 [ 39 , 43 , 46 ], WBC [ 40 , 47 – 49 ], D-dimer [ 42 , 44 , 46 , 50 , 51 ], lactate dehydrogenase (LDH) [ 39 , 42 – 44 , 46 , 47 ], N-terminal pro-B-type natriuretic peptide (NT-proBNP) [ 39 , 52 , 53 ], and Troponin T [ 39 , 54 ], and critical illness scores, such as APACHE II [ 55 – 57 ], SOFA [ 55 , 56 , 58 – 60 ], SAPS [ 61 – 64 ], and CURB65 [ 59 , 61 , 65 ], to evaluate the prognosis of patients with COVID-19. The APACHE II and SOFA scoring systems require the worst values of the clinical and biological parameters to be recorded within 24 h of admission [ 66 ].…”

Circulating Mid-regional Proadrenomedullin is a predictor of mortality in patients with COVID-19: a systematic review and meta-analysis

“…The study population we included had different severities of illness, and the overall mortality rate was 19%. Many studies have used various biomarkers, such as CRP [39][40][41][42][43][44], PCT [39,43,45,46], IL-6 [39,43,46], WBC [40,[47][48][49], D-dimer [42,44,46,50,51], lactate dehydrogenase (LDH) [39,[42][43][44]46,47], N-terminal pro-B-type natriuretic peptide (NT-proBNP) [39,52,53], and Troponin T [39,54], and critical illness score, such as APACHEII [55][56][57], SOFA [55,56,[58][59][60], SAPS [61-64], and CURB65 [59,61,65], to evaluate the prognosis of patients with COVID-19. The APACHE II and SOFA scoring systems require the worst values of the clinical and biological parameters to be recorded within 24 h of admission [66].…”