Risk of Seven-Day Worsening and Death: A New Clinically Derived COVID-19 Score

Viruses

Francesco Pugliese¹  Bruno Cirillo²  Silvia Di Bari³  Giancarlo Iaiani³  Lorenzo Volpicelli³  Alessia Cruciata³  Gloria Taliani³  Gioacchino Galardo⁴  Daniela Pellegrino⁵ 

[1] Department of General Surgery and Surgical Specialities “Paride Stefanini”, “Policlinico Umberto I” Hospital, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy;Department of Surgery “Pietro Valdoni”, “Policlinico Umberto I” Hospital, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy;Infectious and Tropical Medicine Unit, Department of Public Health and Infectious Diseases, “Policlinico Umberto I” Hospital, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy;Medical Emergency Unit, Department of Emergency, “Policlinico Umberto I” Hospital, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy;Pulmonology, Respiratory and Critical Care Unit, Department of Public Health and Infectious Diseases, “Policlinico Umberto I” Hospital, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy;

关键词: SARS-CoV-2;    COVID-19;    risk of death;    risk of worsening;    clinical score;    prognostic score;   

DOI  :  10.3390/v14030642

来源: DOAJ

【 摘 要 】

This monocentric, retrospective, two-stage observational study aimed to recognize the risk factors for a poor outcome in patients hospitalized with SARS-CoV-2 infection, and to develop and validate a risk score that identifies subjects at risk of worsening, death, or both. The data of patients with SARS-CoV-2 infection during the first wave of the pandemic were collected and analyzed as a derivation cohort. Variables with predictive properties were used to construct a prognostic score, which was tried out on a validation cohort enrolled during the second wave. The derivation cohort included 494 patients; the median age was 62 and the overall fatality rate was 22.3%. In a multivariable analysis, age, oxygen saturation, neutrophil-to-lymphocyte ratio, C-reactive protein and lactate dehydrogenase were independent predictors of death and composed the score. A cutoff value of 3 demonstrated a sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) of 93.5%, 68.5%, 47.4% and 97.2% for death, and 84.9%, 84.5%, 79.6% and 87.9% for worsening, respectively. The validation cohort included 415 subjects. The score application showed a Se, Sp, PPV and NPV of 93.4%, 61.6%, 29.5% and 98.1% for death, and 81%, 76.3%, 72.1% and 84.1% for worsening, respectively. We propose a new clinical, easy and reliable score to predict the outcome in hospitalized SARS-CoV-2 patients.

【 授权许可】

Unknown