A novel scoring system for early assessment of the risk of the COVID-19-associated mortality in hospitalized patients: COVID-19 BURDEN

Abstract

Background Corona Virus Disease 2019 (COVID-19) presentations range from those similar to the common flu to severe pneumonia resulting in hospitalization with significant morbidity and/or mortality. In this study, we made an attempt to develop a predictive scoring model to improve the early detection of high risk COVID-19 patients by analyzing the clinical features and laboratory data available on admission. Methods We retrospectively included 480 consecutive adult patients, aged 21–95, who were admitted to Faghihi Teaching Hospital. Clinical and laboratory features were collected from the medical records and analyzed using multiple logistic regression analysis. The final data analysis was utilized to develop a simple scoring model for the early prediction of mortality in COVID-19 patients. The score given to each associated factor was based on the coefficients of the regression analyses. Results A novel mortality risk score (COVID-19 BURDEN) was derived, incorporating risk factors identified in this cohort. CRP (> 73.1 mg/L), O2 saturation variation (greater than 90%, 84–90%, and less than 84%), increased PT (> 16.2 s), diastolic blood pressure (≤ 75 mmHg), BUN (> 23 mg/dL), and raised LDH (> 731 U/L) were the features constituting the scoring system. The patients are triaged to the groups of low- (score < 4) and high-risk (score ≥ 4) groups. The area under the curve, sensitivity, and specificity for predicting mortality in patients with a score of ≥ 4 were 0.831, 78.12%, and 70.95%, respectively. Conclusions Using this scoring system in COVID-19 patients, the patients with a higher risk of mortality can be identified which will help to reduce hospital care costs and improve its quality and outcome.

Hemodynamic, Oxygenation and Lymphocyte Parameters Predict COVID-19 Mortality

“…Oxygen saturation in critically ill patients may reflect microcirculatory conditions, which will also be associated with laboratory markers such as lactate and acid-base deficiency [ 32 ]. Imanieh et al are also in line with this study, integrating oxygen saturation as one of the scoring categories [ 30 ].…”

“…Altschul et al included MAP ≤ 60 mmHg as one of the variables related to the high mortality rate of COVID-19 in their study [29]. An analysis of the effect of low MAP as one of the risk factors that affect the severity of COVID-19 has also been stated in other studies [16,17,30].…”

A Simple Risk Formula for the Prediction of COVID-19 Hospital Mortality

“…We find our model very useful compared to the others since it is straightforward to use and does not necessitate many clinical, paraclinical, and laboratory parameters to calculate the risk. The common denominator with other scores [12,[17][18][19][20][21][22][23][24][25][26] was older age and oxygenation status.…”

“…Another risk score incorporated oxygen saturation, CRP > 73:1 mg/L, increased prothrombin time (16.2 s), diastolic blood pressure ≤ 75 mmHg, lactate dehydrogenase, and blood urea nitrogen > 23 mg/dL as primary risk factors for hospital mortality of COVID-19 [25].…”

Forecasting COVID-19 Inpatient Mortality using Fundamental Parameters in Resource-Constrained Settings: a Countrywide Multi-Center Cohort Study

“…Numerous scoring systems were developed worldwide to predict mortality and classify disease severity using different factors [33][34][35] , offering selection criteria to lead such decisions in limited hospitalization capacity. Nevertheless, most of these scores remained too detailed or too demanding to be applied in poor-resourced settings, where they are needed the most.…”