MuLBSTA score is a useful tool for predicting COVID-19 disease behavior

Abstract

Background: The prediction of COVID-19 disease behavior in the early phase of infection is challenging but urgently needed. MuLBSTA score is a scoring system that predicts the mortality of viral pneumonia induced by a variety of viruses, including coronavirus, but the scoring system has not been verified in novel coronavirus pneumonia. The aim of this study was to validate this scoring system for estimating the risk of disease worsening in patients with COVID-19. Methods: This study included the patients who were treated between April 1 st and March 13 th , 2020. The patients were classified into mild, moderate, and severe groups according to the extent of respiratory failure. MuLBSTA score was applied to estimate the risk of disease worsening in each severity group and we validated the utility of the scoring system. Results: A total of 72 patients were analyzed. Among the 46 patients with mild disease, 17 showed disease progression to moderate or severe disease after admission. The model showed a sensitivity of 100% and a specificity of only 34.5% with a cut-off value of 5 points. Among the 55 patients with mild or moderate disease, 6 deteriorated to severe disease, and the model showed a sensitivity of 83.3% and a specificity of 71.4% with a cut-off value of 11 points. Conclusions: This study showed that MuLBSTA score is a potentially useful tool for predicting COVID-19 disease behavior. This scoring system may be used as one of the criteria to identify high-risk patients worsening to life-threatening status.

Clinical Management of Adult Patients with COVID-19 Outside Intensive Care Units: Guidelines from the Italian Society of Anti-Infective Therapy (SITA) and the Italian Society of Pulmonology (SIP)

“…Other scoring systems have been proposed for stratifying patients with COVID-19 at high or low risk for disease progression and/or poor outcome at the time of hospital admission [31][32][33][34]. The MuLBSTA score is a fatality prediction score for viral pneumonia that includes six variables, namely multilobal infiltration, lymphopenia, bacterial co-infection, smoking history, age, and hypertension [32,34,35]. The MuLBSTA score has also been proposed to avoid hospitalization in patients with COVID-19, since none of the patients with less than five points showed disease progression.…”

“…The MuLBSTA score has also been proposed to avoid hospitalization in patients with COVID-19, since none of the patients with less than five points showed disease progression. However, the cohort was composed of hospitalized patients and the sample size was small (n = 72) [34]. Another prognostic score, named CALL and developed in a cohort of 208 hospitalized patients with COVID-19, is based on comorbidities, age, blood lymphocyte count, and serum lactate dehydrogenase (LDH) value [31].…”

“…Finally, there is still no evidence that implementation of severity tools into clinical practice results in better prognosis, lower costs, and lower mortality in patients with COVID-19. None of the available tools has been currently fully validated and is ready for widespread implementation in clinical practice [30][31][32][33][34][35].…”

Establishment of Routine Clinical Indicators-Based Nomograms for Predicting the Mortality in Patients With COVID-19

“…The previous studies have reported that the risk factors, such as age, pre-existing comorbidities, and neutrophil-to-lymphocyte ratio (NLR) were associated with higher mortality risk in COVID-19 (1,(4)(5)(6)(7). During the initial outbreak of COVID-19 in Wuhan, the MuLBSTA score (8) was reported to be associated with the outcome of COVID-19 in a few observational studies (9). However, the MuLBSTA score was developed to assess the outcome of influenza A, rhinovirus, and other respiratory virus pneumonia and has not been rigorously tested in predicting the risk of death in patients with COVID-19.…”

Establishment of Routine Clinical Indicators-Based Nomograms for Predicting the Mortality in Patients with COVID-19

“…The MuLBSTA score [8], developed to assess the outcome of viral pneumonia, was reported to be associated with the outcome of COVID-19 in a few observational studies during the initial outbreak of COVID-19 in Wuhan (China) [9]. COVID-19 differed signi cantly from in uenza A, rhinovirus, and other respiratory virus pneumonias that were used to build up the MuLBSTA score.…”