Utility of severity assessment tools in COVID-19 pneumonia: a multicentre observational study.
Ahmed, Asim Alderazi, Sayed A Aslam, Rumaisa Barkat, Barooq Barker, Bethan L Bhat, Rahul Cassidy, Samuel Crowley, Louise E Dosanjh, Davinder Ps Ebrahim, Hussain
Ahmed, Asim
Alderazi, Sayed A
Aslam, Rumaisa
Barkat, Barooq
Barker, Bethan L
Bhat, Rahul
Cassidy, Samuel
Crowley, Louise E
Dosanjh, Davinder Ps
Ebrahim, Hussain
Abstract
Background: Severity scores in pneumonia and sepsis are being applied to SARS-CoV-2 infection. We aimed to assess whether these severity scores are accurate predictors of early adverse outcomes in COVID-19.
Methods: We conducted a multicentre observational study of hospitalised SARS-CoV-2 infection. We assessed risk scores (CURB65, qSOFA, Lac-CURB65, MuLBSTA and NEWS2) in relation to admission to intensive care or death within 7 days of admission, defined as early severe adverse events (ESAE). The 4C Mortality Score was also assessed in a sub-cohort of patients.
Findings: In 2,387 participants, the overall mortality was 18%. In all scores examined, increasing score was associated with increased risk of ESAE. Area under the curve (AUC) to predict ESAE for CURB65, qSOFA, Lac-CURB65, MuLBSTA and NEWS2 were 0.61, 0.62, 0.59, 0.59 and 0.68, respectively. AUC to predict ESAE was 0.60 with ISARIC 4C Mortality Score.
Conclusion: None of the scores examined accurately predicted ESAE in SARS-CoV-2 infection. Non-validated scores should not be used to inform clinical decision making in COVID-19.
Keywords: COVID-19; collaborative; pneumonia; severity score.
Affiliations
Royal Stoke University Hospital; George Eliot Hospital; Good Hope Hospital; Russells Hall Hospital; Worcestershire Acute Hospitals NHS Trust; Queen Elizabeth Hospital Birmingham; Sandwell and West Birmingham NHS Trust
Citations
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Date
2022-01
Type
Article
Subject
Citation
Ahmed A, Alderazi SA, Aslam R, Barkat B, Barker BL, Bhat R, Cassidy S, Crowley LE, Dosanjh DP, Ebrahim H, Elndari N, Gardiner C, Gogokhia A, Grudzinska FS, Gurung MT, Hughes T, Ismail I, Iredale N, Irshad S, Johnson S, Kavanagh D, Knight T, Livesey A, Lugg ST, Marathe M, McDougall A, Nawaz W, Nettleton K, O'Flynn L, Okoth K, Parekh D, Perry R, Pudney EJ, Sadiq A, Soge O, Soloman R, Soltan M, Strecker M, Thein OS, Thickett D, Thomas A, Thornton R. Utility of severity assessment tools in COVID-19 pneumonia: a multicentre observational study. Clin Med (Lond). 2022 Jan;22(1):63-70.