The CALL Score for Predicting Outcomes in Patients With COVID-19

Grifoni, Elisa; Valoriani, Alice; Cei, Francesco; Vannucchi, Vieri; Moroni, Federico; Pelagatti, Lorenzo; Tarquini, Roberto; Landini, Giancarlo; Masotti, Luca

doi:10.1093/cid/ciaa686

Cited by 39 publications

(35 citation statements)

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“…These findings differ from the values reported in the derivation and validation study carried out in Chinese patients, with an area under the curve of 0.91 (IC95%: 0.86 to 0.94) [3]. Similarly, when the model was evaluated in the Italian population, the CALL score's predictive power as a predictor of hospital mortality was good (AUC 0.768, IC95%: 0.705 to 0.823), differing from our result [8]. And in another study conducted in Pakistan, the call score was strongly associated with progression and mortality in patients with COVID-19 [9].…”

Section: Contrast With the Literaturecontrasting

confidence: 99%

Clinical Performance of the Call Score for the Prediction of Admission to Icu and Death in Hospitalized Patients With Covid-19 Pneumonia in a Reference Hospital in Peru

Pichardo-Rodriguez

Saavedra-Velasco

Peña-Oscuvilca

et al. 2021

Preprint

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Objective: Determine the CALL SCORE's diagnostic accuracy for the prediction of ICU admission and death in patients hospitalized for COVID-19 pneumonia in a reference hospital in Peru. Methods: We performed an analytical cross-sectional observational study. We included patients with COVID-19 pneumonia treated at the "Dos de Mayo" National Hospital. Patients over 18 years old with a diagnosis confirmed by rapid or molecular testing were included. Those with an incomplete, illegible, or missing medical history and/or bacterial or fungal pneumonia were excluded. Data were extracted from medical records. The primary outcomes were mortality and admission to the ICU. The Call Score was calculated for each patient (4 to 13 points) and classified into three risk groups. Summary measures were presented for qualitative and quantitative variables. The area under the model curve and the operational characteristics (sensitivity, specificity) were calculated for the best cut-off point. Results: The Call Score reported an area under the curve of 0.59 (IC95%: 0.3 to 0.07), p = 0.43 for predicting death. However, for a cut-off point of 5.5, a sensitivity of 87% and a specificity of 65% were obtained. The area under the curve for ICU admission was 0.67 (95%CI: 0.3 to 0.07), p = 0.43; the 5.5 cut-off point showed a sensitivity of 82% and a specificity of 51%. Conclusions: The Call Score shows a low performance for predicting mortality and admission to the ICU in Peruvian patients.

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Section: Contrast With the Literaturecontrasting

confidence: 99%

Clinical Performance of the Call Score for the Prediction of Admission to Icu and Death in Hospitalized Patients With Covid-19 Pneumonia in a Reference Hospital in Peru

Pichardo-Rodriguez

Saavedra-Velasco

Peña-Oscuvilca

et al. 2021

Preprint

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“…In one study, the CALL score has turned out to have a good prognostic index for in-hospital mortality but not for disease progression [ 20 ]. However, a significant amount of patients with higher CALL scores in this study population developed progression of disease, as Ji et al said that CALL score with a cut off value of nine points showed positive and negative predictive values of 78.3% and 11.9% respectively [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

CALL Score and RAS Score as Predictive Models for Coronavirus Disease 2019

Kamran¹,

Mirza²,

Moeed³

et al. 2020

Cureus

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Background: Coronavirus disease 2019 (COVID-19) is a novel infectious disease of multi-system involvement with significant pulmonary manifestations. So far, many prognostic models have been introduced to guide treatment and resource management. However, data on the impact of measurable respiratory parameters associated with the disease are scarce. Objective: To demonstrate the role of Comorbidity-Age-Lymphocyte count-Lactate dehydrogenase (CALL) score and to introduce Respiratory Assessment Scoring (RAS) model in predicting disease progression and mortality in COVID-19. Methodology: Data of 252 confirmed COVID-19 patients were collected at Pak Emirates Military Hospital (PEMH) from 10th April 2020 to 31st August 2020. The CALL score and proposed factors of RAS model, namely respiratory rate, oxygen saturation at rest, alveolar arterial gradient and minimal exercise desaturation test, were calculated on the day of admission. Progression of disease was defined and correlated with measured variables. Univariate and multivariate Cox regression analysis for each variable, its hazard ratio (HR) and 95% confidence interval (CI) were calculated, and a nomogram was made using the high-risk respiratory parameters to establish the RAS model. Results: Progression of disease and death was observed in 124 (49.2%) and 49 (19.4%) patients, respectively. Presence of more than 50% of chest infiltrates was significantly associated with worsening disease and death (p-value <0.001). Death was observed in 100% of patients who had critical disease category on presentation. Regression analysis showed that the presence of comorbidity (n: 180), in contrast to other variables of CALL score, was not a good prognosticator of disease severity (p-value: 0.565). Nonetheless, the CALL model itself was validated to be a reliable prognostic indicator of disease progression and mortality. Some 10 feet oxygen desaturation test (HR: 0.99, 95%CI: 0.95-1.04, p-value: 0.706) was not a powerful predictor of the progression of disease. However, respiratory rate of more than 30 breaths/minute (b/m) (HR: 3.03, 95%CI: 1.77-5.19), resting oxygen saturation of less than 90% (HR: 2.41, 95%CI: 1.15-5.06), and an elevated alveolar-arterial oxygen gradient (HR: 2.14, 95%CI: 1.04-4.39) were considered statistically significant highrisk predictors of disease progression and death, in the formed RAS model. The model resulted in 85% (95%CI: 80%-89%) of area under the receiver operating characteristic curve (AUROC), with substantial positive (76%, 95%CI: 68%-83%) and negative predictive values (80%, 95%CI: 73%-87%) for a cutoff value of seven. Patients with higher CALL and RAS scores also resulted in higher mortality. Conclusion: CALL and RAS scores were strongly associated with progression and mortality in patients with COVID-19.

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“…First, the COVID-GRAM [ 14 ] is able to predict a risk score based on outcomes of COVID-10-infected patients during the hospital admission, which included ten variables, namely: chest radiographic abnormality; age; dyspnea; haemoptysis; unconsciousness; cancer history; number of comorbidities; lactate dehydrogenase; direct bilirubin; and NLR. Second, the C: co-morbidity, A: age, L: lymphocyte count, L: lactate dehydrogenase (CALL) score involves four items and was aimed at predicting the clinical worsening, but not the progression of severe cases [ 15 ].…”

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confidence: 99%