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; Elndari, Najla; Gardiner, Claudia; Gogokhia, Atena; Grudzinska, Frances S; Gurung, Megha T; Hughes, Terry; Ismail, Iyad; Iredale, Natasha; Irshad, Sannaan; Johnson, Sarah; Kavanagh, Diana; Knight, Thomas; Livesey, Alana; Lugg, Sebastian T; Marathe, Manoj; McDougall, Andrew; Nawaz, Wasim; Nettleton, Kimberly; O'Flynn, Lauren; Okoth, Kelvin; Parekh, Dhruv; Perry, Rita; Pudney, Elizabeth J; Sadiq, Ambreen; Soge, Olutobi; Soloman, Rhania; Soltan, Marina; Strecker, Martin; Thein, Onn S; Thickett, David; Thomas, Ajit; Thornton, Riah

Affiliation

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

Publication date

2022-01

Subject

Respiratory medicine

Metadata

Show full item record

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.

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.

Type

Article