Predictive Value of 5 Early Warning Scores for Critical COVID-19 Patients

Abstract

Objective A simple evaluation tool for patients with novel coronavirus disease (COVID-19) could assist the physicians to triage COVID-19 patients effectively and rapidly. This study aimed to evaluate the predictive value of five early warning scores based on the admission data of critical COVID-19 patients. Methods Overall, medical records of 319 COVID-19 patients were included in the study. Demographic and clinical characteristics on admission were used for calculating the Standardized Early Warning Score (SEWS), national early warning score (NEWS), national early warning score2 (NEWS2), Hamilton early warning score (HEWS), and Modified Early Warning Score (MEWS). Data on the outcomes (survival or death) were collected for each case and extracted for overall and subgroup analysis. Receiver operating characteristic curve analyses were performed. Results The area under the receiver operating characteristic curve for the SEWS, NEWS, NEWS2, HEWS and MEWS in predicting mortality were 0.841 (95% CI: 0.765-0.916), 0.809 (95% CI: 0.727-0.891), 0.809 (95% CI: 0.727-0.891), 0.821 (95% CI: 0.748-0.895), and 0.670 (95% CI: 0.573-0.767), respectively. Conclusion SEWS, NEWS, NEWS2 and HEWS demonstrated moderate discriminatory power and therefore, offer potential utility as prognostic tools for screening severely ill COVID-19 patients. However, MEWS is not a good prognostic predictor for COVID-19.

Effectiveness of 6 Scores in Predicting the Death Risk of COVID-19

“…As stated in the original, we agree quite well that SEWS, HEWS, NEWS and NEWS2 have the potential to be used as tools for screening severely and critically ill COVID-19 patients [1]. Meanwhile, another conclusion can be drawn that REMS does well in predicting the mortality risk of COVID-19 patients and it's the most accurate in this research, so we hold the view that REMS also has great potential in COVID-19 evaluation.…”

“…The article by Hai Hu et al is very meaningful [1]. We agree that a series of Early Warning Scores, including Standardized Early Warning Score (SEWS), National Early Warning Score (NEWS), National Early Warning Score 2 (NEWS2) and Hamilton Early Warning Score (HEWS), have the potential to be used as screening tools for predicting the mortality risk of severe coronavirus disease (COVID-19) patients.…”

Epidemiology and clinical features of common community human coronavirus disease

“…Recent studies have shown that frailty and complaints general weakness, exhaustion, and low physical activity in elderly patients are related to the onset and prognosis of critical illness (23)(24)(25). NEWS has been reported to predict prognosis well in COVID 19 patients (26). Patients with OC43 had two-fold odds of requiring O 2 or intubation than those with other strains, while no difference in mortality or ICU admission was observed in a study of coronavirus-infected patients receiving acute care (8).…”

Early Warning Scores in Patients with Suspected COVID-19 Infection in Emergency Departments

“…Myrstad et al [ 36 ] evaluated the ability of NEWS2 to predict seven-day mortality and Jang et al [ 23 , 37 ] evaluated the ability of NEWSs and qSOFA to predict 28-day mortality. Covino et al [ 23 ] and Gidari et al [ 14 ] studied whether NEWSs and other scores could predict the need for ICUs or Sixt et al [ 38 ] and Hu et al [ 39 , 40 ] analyzed the usefulness of NEWS2 at day 7 in relation to hospitalization. All of the aforementioned studies were developed using small cohorts (from 66 to 334 cases), different outcomes and with a limited number of EWSs studied.…”