Sequential Organ Failure Assessment (SOFA) Score and Mortality Prediction in Patients With Severe Respiratory Distress Secondary to COVID-19

Abstract

Background This study looks at the validity of the sequential organ failure assessment score (SOFA) in detecting mortality in patients with Coronavirus disease of 2019 (COVID-19) pneumonia. Also, it is looking to determine the optimal SOFA score that will discriminate between mortality and survival. Methods It is a retrospective chart review of the patients admitted to Henry Ford Hospital from March 2020 to December 2020 with COVID-19 pneumonia who developed severe respiratory distress. We collected the following information; patient demographics (age, sex, body mass index), co-morbidities (history of diabetes mellitus, chronic kidney disease, chronic obstructive pulmonary disease, coronary artery disease, or cancer), SOFA scores (the ratio of arterial oxygen tension (PaO 2 ) to the fraction of inspired oxygen, Glasgow Coma Scale (GCS) score, mean arterial pressure, serum creatinine level, bilirubin level, and platelet count) as well as inpatient mortality. Results There were 320 patients; out of these, 111 were intubated. The receiver operating characteristic (ROC) curve for SOFA at the moment of inclusion in the study had an area under the curve of 0.883. The optimal point for discrimination between mortality and survival is SOFA of 5. A SOFA score of less than two is associated with 100% survival, while a score of more than 11 is associated with 100% mortality. Conclusions SOFA score in COVID-19 patients with severe respiratory distress strongly correlates with the initial SOFA score. It is a valuable tool for predicting mortality in COVID-19 patients.

Evaluation of Risk Factors Affecting Mortality in Patients with the Diagnosis of COVID-19 in the Secondary Intensive Care Unit: A Single Center Retrospective Study

“…APACHE-II ve SOFA skorları, kritik hastaları değerlendirmek ve mortalite tahmini için uzun yıllardır kullanılan skorlama sistemleridir (26). Her ne kadar birkaç çalışmada COVID-19 hastalarının mortalite tahminine yönelik yeni spesifik skorlama sistemleri kullanılmışsa da hâlen kritik hastalarda uzun yıllardır uygulanan tanıdık ve mevcut skorlama sistemleri COVID-19 hastalarının değerlendirilmesinde de yaygın olarak kullanılmaktadır (27)(28)(29). Çalışmamızda literatürle uyumlu bir şekilde APACHE-II ve SOFA skorları sağ kalan hastalara göre ölen hastalarda anlamlı yüksek bulunmuş ve bu iki skorun çok değişkenli regresyon analizinde mortaliteyi tahmin etmede anlamlı olarak etkili olduğu gösterilmiştir.…”

Unexpected Thrombocytopenia in a Parturient With Evans Syndrome Complicated by COVID-19 Infection

“…Despite data suggesting a correlation of SOFA score with COVID-19 pneumonia, thrombocytopenia from ES can be a confounding factor, as in this case [ 14 ]. Assessing the risk and benefits of administering methergine in these cases is worth noting to avoid pulmonary artery vasoconstriction and myocardial injury [ 15 ]. The pathophysiology of ES remains poorly understood, but thrombosis is a known complication of ITP and AIHA [ 16 ].…”

When to Use Antibiotics in COVID-19: A Proposal Based on Questions

“…Regardless of clinical classification, patients should be closely monitored. In critically ill patients, a useful tool is the calculation of sequential organ failure assessment (SOFA) and delta-SOFA, which determines the degree of organic dysfunction upon admission to the ICU and during its stay [49,50].…”

“…Regardless of clinical classification, patients should be closely monitored. In critically ill patients, a useful tool is the calculation of sequential organ failure assessment (SOFA) and delta-SOFA, which determines the degree of organic dysfunction upon admission to the ICU and during its stay [ 49 , 50 ]. In patients with severe disease, it is necessary to perform a chest CT to assess the presence of typical radiological signs of COVID-19 or bacterial processes that indicate taking cultures and early initiation of antibiotic therapy.…”