National Early Warning Score 2 (NEWS2) to predict poor outcome in hospitalised COVID-19 patients in India

Abstract

Background While several parameters have emerged as predictors of prognosis of COVID-19, a simple clinical score at baseline might help early risk stratification. We determined the ability of National Early Warning Score 2 (NEWS2) to predict poor outcomes among adults with COVID-19. Methods A prospective study was conducted on 399 hospitalised adults with confirmed SARS-CoV-2 infection between August and December 2020. Baseline NEWS2 score was determined. Primary outcome was poor outcomes defined as need for mechanical ventilation or death within 28 days. The sensitivity, specificity and Area under the curve were determined for NEWS2 scores of 5 and 6. Results Mean age of patients was 55.5 ± 14.8 years and 275 of 399 (68.9%) were male. Overall mortality was 3.8% and 7.5% had poor outcomes. Median (interquartile range) NEWS2 score at admission was 2 (0–6). Sensitivity and specificity of NEWS 2 of 5 or more in predicting poor outcomes was 93.3% (95% CI: 76.5–98.8) and 70.7% (95% CI: 65.7–75.3) respectively [area under curve 0.88 (95% CI: 0.847–0.927)]. Age, baseline pulse rate, baseline oxygen saturation, need for supplemental oxygen and ARDS on chest X ray were independently associated with poor outcomes. Conclusions NEWS2 score of 5 or more at admission predicts poor outcomes in patients with COVID-19 with good sensitivity and can easily be applied for risk stratification at baseline. Further studies are needed in the Indian setting to validate this simple score and recommend widespread use.

Performance of point‐of‐care severity scores to predict prognosis in patients admitted through the emergency department with COVID‐19

“…qSOFA exhibited the lowest sensitivity and the highest specificity for all outcomes measured in our study. Our results are consistent with prior studies among COVID‐19 patients, which demonstrate a high sensitivity and low specificity for NEWS2 as well as a low sensitivity and high specificity for qSOFA 39–43 44,45 In addition, we observed similar AUROC patterns to the published literature for both NEWS2 and qSOFA 39,40 .…”

A randomized, placebo controlled, double blinded, parallel group clinical study to evaluate the efficacy and safety of AEV01 along with standard care for elderly patients with mild COVID-19

“…National Early Warning score (NEWS2) is another tool that is simple and can be used easily by health care staff to identify high risk patients and escalate clinical care. Such stratification of risk would enable the medical team for quicker decision making and divert more attention, resources and time to those identified as high risk for fatal outcome[ 17 ]. This study had utilized the NEWS tool to predict that a score of more than 5 at admission there will be need for mechanical ventilation and may lead to mortality in COVID-19 patients.…”

COVID-19 Patients’ Health Monitoring System using Fuzzy Ontology and Internet of Things

“…After reviewing and analyzing the data, the physicians completed the questionnaire. We then compared the physician's responses to the results system's output and with the results of Pugazhvannan [37].…”

“…To diagnose COVID-19 patients in a hospital, we used a dataset that was made available on [37]. The presented data set included 399 persons hospitalized at the Pondicherry Institute of Medical Sciences with a confirmed COVID-19 infection.…”