National early warning score (NEWS) 2 predicts hospital mortality from COVID-19 patients

Wibisono, Eric; Hadi, Usman; Bramantono,; Arfijanto, Muhammad Vitanata; Rusli, Musofa; Rahman, Brian Eka; Asmarawati, Tri Pudy; Choirunnisa, Miftahani Leo; Rahayu, Dwi Retno Puji

doi:10.1016/j.amsu.2022.103462

Cited by 14 publications

(11 citation statements)

References 19 publications

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“…In our study, NEWS2 was proven to be a significant predictor of both primary and secondary outcomes. This is comparable to several other studies that assessed NEWS2 predictive strength in COVID-19 patients [ 31 , 32 , 33 , 34 ]. In a multicenter study of 1288 COVID-19 patients treated in hospitals in the west of England [ 31 ], high NEWS2 values upon admission and the highest measured levels of NEWS2 during the in-hospital treatment were predictive for deterioration and ICU transfer, length of stay, and mortality.…”

Section: Discussionsupporting

confidence: 89%

Outcomes in COVID-19 Patients with Pneumonia Treated with High-Flow Oxygen Therapy and Baricitinib—Retrospective Single-Center Study

Obradović

Popović

Banjac

et al. 2023

Life

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Background. The aim of the study was to assess the effect of baricitinib on 28-day all-cause mortality and the progression of respiratory failure in patients needing transfer to the intensive care unit (ICU) with COVID-19 pneumonia treated with high-flow oxygen therapy. Methods. This retrospective study included hospitalized patients with COVID-19 pneumonia treated with high-flow oxygen non-invasive ventilation receiving standard of care (SOC) or SOC in addition to baricitinib. Data on patients’ characteristics, pro-inflammatory markers, D dimer, and National Early Warning Score 2 (NEWS2) values were collected and compared between groups. The primary endpoint was 28-day all-cause in-hospital mortality and the secondary outcome was transfer to the ICU. Results. The study included 125 patients. The primary outcome was observed in 44.8% of them: 27% in the baricitinib group vs. 62% in the SOC group, p < 0.001. Transfer to the ICU ward was significantly lower in the baricitinib group: 29% vs. 81%, p < 0.001. A significant improvement was observed when the baricitinib group was compared to SOC in procalcitonin, CRP, D-dimer, neutrophil-to-lymphocyte ratio values, and NEWS2. Conclusion. Treatment with baricitinib in addition to SOC was associated with reduced mortality and a lower prevalence of transfer to the ICU in hospitalized patients with COVID-19 pneumonia treated with high-flow oxygen non-invasive therapy.

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Section: Discussionsupporting

confidence: 89%

Outcomes in COVID-19 Patients with Pneumonia Treated with High-Flow Oxygen Therapy and Baricitinib—Retrospective Single-Center Study

Obradović

Popović

Banjac

et al. 2023

Life

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“…The study conducted by Jones et al ( 2021 ) [ 38 ] validated the 4C score for Canadian patients obtaining an AUC of 0.770 (95% CI 0.790–0.870). In addition, the accuracy of this prediction model (4C Mortality), beyond NEWS and CURB-65 was compared among the Romanian population with AUC of 0.818 (95% CI 0.718–0.919), 0.861 (95% CI 0784–0.939), and 0.801 (95% CI 0.681–0.922), respectively [ 39 , 40 ]. In the present study, we tested these aforementioned scores, together with other scores commonly used for general COVID-19 patients, and ABC 2 -SPH outperformed all of them.…”

Section: Discussionmentioning

confidence: 99%

Mechanical ventilation and death in pregnant patients admitted for COVID-19: a prognostic analysis from the Brazilian COVID-19 registry score

Reis

Pires

Ramos

et al. 2023

BMC Pregnancy Childbirth

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Background The assessment of clinical prognosis of pregnant COVID-19 patients at hospital presentation is challenging, due to physiological adaptations during pregnancy. Our aim was to assess the performance of the ABC2-SPH score to predict in-hospital mortality and mechanical ventilation support in pregnant patients with COVID-19, to assess the frequency of adverse pregnancy outcomes, and characteristics of pregnant women who died. Methods This multicenter cohort included consecutive pregnant patients with COVID-19 admitted to the participating hospitals, from April/2020 to March/2022. Primary outcomes were in-hospital mortality and the composite outcome of mechanical ventilation support and in-hospital mortality. Secondary endpoints were pregnancy outcomes. The overall discrimination of the model was presented as the area under the receiver operating characteristic curve (AUROC). Overall performance was assessed using the Brier score. Results From 350 pregnant patients (median age 30 [interquartile range (25.2, 35.0)] years-old]), 11.1% had hypertensive disorders, 19.7% required mechanical ventilation support and 6.0% died. The AUROC for in-hospital mortality and for the composite outcome were 0.809 (95% IC: 0.641–0.944) and 0.704 (95% IC: 0.617–0.792), respectively, with good overall performance (Brier = 0.0384 and 0.1610, respectively). Calibration was good for the prediction of in-hospital mortality, but poor for the composite outcome. Women who died had a median age 4 years-old higher, higher frequency of hypertensive disorders (38.1% vs. 9.4%, p < 0.001) and obesity (28.6% vs. 10.6%, p = 0.025) than those who were discharged alive, and their newborns had lower birth weight (2000 vs. 2813, p = 0.001) and five-minute Apgar score (3.0 vs. 8.0, p < 0.001). Conclusions The ABC2-SPH score had good overall performance for in-hospital mortality and the composite outcome mechanical ventilation and in-hospital mortality. Calibration was good for the prediction of in-hospital mortality, but it was poor for the composite outcome. Therefore, the score may be useful to predict in-hospital mortality in pregnant patients with COVID-19, in addition to clinical judgment. Newborns from women who died had lower birth weight and Apgar score than those who were discharged alive.

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“…This study revealed a promising result that NEWS 2 can predict the death of patients with COVID-19. However, this cross-sectional study was confined to a smaller population [ 21 ]. Further investigation on discrimination comparing other EWS and NEWS 2 may be conducted on patients with COVID-19.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Early Warning Scores on In-Hospital Mortality in COVID-19 Patients: A Tertiary Hospital Study from Taiwan

Tsai

Chen

et al. 2023

Medicina

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Coronavirus disease 2019 (COVID-19) remains a global pandemic. Early warning scores (EWS) are used to identify potential clinical deterioration, and this study evaluated the ability of the Rapid Emergency Medicine score (REMS), National Early Warning Score (NEWS), and Modified EWS (MEWS) to predict in-hospital mortality in COVID-19 patients. This study retrospectively analyzed data from COVID-19 patients who presented to the emergency department and were hospitalized between 1 May and 31 July 2021. The area under curve (AUC) was calculated to compare predictive performance of the three EWS. Data from 306 COVID-19 patients (61 ± 15 years, 53% male) were included for analysis. REMS had the highest AUC for in-hospital mortality (AUC: 0.773, 95% CI: 0.69–0.85), followed by NEWS (AUC: 0.730, 95% CI: 0.64–0.82) and MEWS (AUC: 0.695, 95% CI: 0.60–0.79). The optimal cut-off value for REMS was 6.5 (sensitivity: 71.4%; specificity: 76.3%), with positive and negative predictive values of 27.9% and 95.4%, respectively. Computing REMS for COVID-19 patients who present to the emergency department can help identify those at risk of in-hospital mortality and facilitate early intervention, which can lead to better patient outcomes.

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National early warning score (NEWS) 2 predicts hospital mortality from COVID-19 patients

Cited by 14 publications

References 19 publications

Outcomes in COVID-19 Patients with Pneumonia Treated with High-Flow Oxygen Therapy and Baricitinib—Retrospective Single-Center Study

Outcomes in COVID-19 Patients with Pneumonia Treated with High-Flow Oxygen Therapy and Baricitinib—Retrospective Single-Center Study

Mechanical ventilation and death in pregnant patients admitted for COVID-19: a prognostic analysis from the Brazilian COVID-19 registry score

Evaluation of Early Warning Scores on In-Hospital Mortality in COVID-19 Patients: A Tertiary Hospital Study from Taiwan

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