The usefulness of NEWS2 at day 7 of hospitalization in predicting COVID-19 evolution and as an early endpoint in therapeutic trials

Sixt, Thibault; Moretto, Florian; Devilliers, H.; Abdallahoui, M.; Eberl, Isabelle; Rogier, T.; Duong, Michel; Salmon-Rousseau, Arnaud; Buisson, Marielle; Estève, Clémentine; Chavanet, P.; Catherine, François-Xavier; Blot, Mathieu; Piroth, Lionel

doi:10.1016/j.jinf.2020.09.034

Cited by 8 publications

(11 citation statements)

References 5 publications

(5 reference statements)

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“…NEWS has already been evaluated for its usefulness in patients with COVID‐19, with the present study also in line with similar studies (Blomaard, Mooijaart, et al, 2020 ; Fan et al, 2020 ; Gidari et al, 2020 ; Sixt et al, 2021 ). Moreover, the role of comorbidities in the prognosis of patients with COVID‐19 has also been studied (Jain & Yuan, 2020 ; Price et al, 2020 ; Wang et al, 2020 ; Zhou et al, 2020 ).…”

Section: Discussionsupporting

confidence: 89%

Comorbidity‐adjusted NEWS predicts mortality in suspected patients with COVID‐19 from nursing homes: Multicentre retrospective cohort study

Martin-Rodríguez

Sanz-García

Guijarro

et al. 2021

Journal of Advanced Nursing

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Aims To assess the prognostic accuracy of comorbidity‐adjusted National Early Warning Score in suspected Coronavirus disease 2019 patients transferred from nursing homes by the Emergency Department. Design Multicentre retrospective cohort study. Methods Patients transferred by high‐priority ambulances from nursing homes to Emergency Departments with suspected severe acute respiratory syndrome coronavirus 2 infection, from March 12 to July 31 2020, were considered. Included variables were: clinical covariates (respiratory rate, oxygen saturation, systolic blood pressure, heart rate, temperature, level of consciousness and supplemental oxygen use), the presence of comorbidities and confirmatory analytical diagnosis of severe acute respiratory syndrome coronavirus 2 infection. The primary outcome was a 2‐day mortality rate. The discriminatory capability of the National Early Warning Score was assessed by the area under the receiver operating characteristic curve in two different cohorts, the validation and the revalidation, which were randomly selected from the main cohort. Results A total of 337 nursing homes, 10 advanced life support units, 51 basic life support units and 8 hospitals in Spain entailing 1,324 patients (median age 87 years) was involved in this study. Two‐day mortality was 11.5% (152 cases), with a positivity rate of severe acute respiratory syndrome coronavirus 2 of 51.2%, 77.7% of hospitalization from whom 1% was of intensive care unit admission. The National Early Warning Score results for the revalidation cohort presented an AUC of 0.771, and of 0.885, 0.778 and 0.730 for the low‐, medium‐ and high‐level groups of comorbidities. Conclusion The comorbidity‐adjusted National Early Warning Score provides a good short‐term prognostic criterion, information that can help in the decision‐making process to guide the best strategy for each older adult, under the current pandemic. Impact What problem did the study address? Under the current coronavirus disease 2019 pandemic, targeting older adults at high risk of deterioration in nursing homes remains challenging. What were the main findings? Comorbidity‐adjusted National Early Warning Score helps to forecast the risk of clinical deterioration more accurately. Where and on whom will the research have impact? A high NEWS, with a low level of comorbidity is associated with optimal predictive performance, making these older adults likely to benefit from continued follow up and potentially hospital referral under the current coronavirus disease 2019 pandemic.

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Section: Discussionsupporting

confidence: 89%

Comorbidity‐adjusted NEWS predicts mortality in suspected patients with COVID‐19 from nursing homes: Multicentre retrospective cohort study

Martin-Rodríguez

Sanz-García

Guijarro

et al. 2021

Journal of Advanced Nursing

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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

Martin-Rodríguez

Conty

Sanz-García

et al. 2021

JPM

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Early warning scores (EWSs) help prevent and recognize and thereby act as the first signs of clinical and physiological deterioration. The objective of this study is to evaluate different EWSs (National Early Warning Score 2 (NEWS2), quick sequential organ failure assessment score (qSOFA), Modified Rapid Emergency Medicine Score (MREMS) and Rapid Acute Physiology Score (RAPS)) to predict mortality within the first 48 h in patients suspected to have Coronavirus disease 2019 (COVID-19). We conducted a retrospective observational study in patients over 18 years of age who were treated by the advanced life support units and transferred to the emergency departments between March and July of 2020. Each patient was followed for two days registering their final diagnosis and mortality data. A total of 663 patients were included in our study. Early mortality within the first 48 h affected 53 patients (8.3%). The scale with the best capacity to predict early mortality was the National Early Warning Score 2 (NEWS2), with an area under the curve of 0.825 (95% CI: 0.75–0.89). The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive patients presented an area under the curve (AUC) of 0.804 (95% CI: 0.71–0.89), and the negative ones with an AUC of 0.863 (95% CI: 0.76–0.95). Among the EWSs, NEWS2 presented the best predictive power, even when it was separately applied to patients who tested positive and negative for SARS-CoV-2.

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“…However, they reported the results of only 17 elderly patients. Kim et al showed that NEWS2 scores on D0 significantly differed in noncritical and critical patients (2.6 ± 2.6 vs 8.2 ± 3.3; p < 0.001) [ 9 ]. In the study of Volff et al the AUC value of NEWS score to predict ICU admission or death was 0.74, in consistent with our result.…”

Section: Discussionmentioning

confidence: 99%

National Early Warning Score 2 and Laboratory Predictors Correlate with Clinical Deterioration in Hospitalized Patients with Covid-19

et al. 2021

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Aim: We aimed to determine the prognostic values of the National Early Warning Score 2 (NEWS2) and laboratory parameters during the first week of COVID-19. Materials & methods: All adult patients who were hospitalized for confirmed COVID-19 between 11 March and 11 May 2020 were retrospectively included. Results: Overall, 611 patients were included. Our results showed that NEWS2, procalcitonin, neutrophil/lymphocyte ratio and albumin at D0, D3, D5 and D7 were the best predictors for clinical deterioration defined as a composite of ICU admission during hospitalization or in-hospital death. Procalcitonin had the highest odds ratio for clinical deterioration on all days. Conclusion: This study provides a list of several laboratory parameters correlated with NEWS2 and potential predictors for clinical deterioration in patients with COVID-19.

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The usefulness of NEWS2 at day 7 of hospitalization in predicting COVID-19 evolution and as an early endpoint in therapeutic trials

Cited by 8 publications

References 5 publications

Comorbidity‐adjusted NEWS predicts mortality in suspected patients with COVID‐19 from nursing homes: Multicentre retrospective cohort study

Comorbidity‐adjusted NEWS predicts mortality in suspected patients with COVID‐19 from nursing homes: Multicentre retrospective cohort study

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

National Early Warning Score 2 and Laboratory Predictors Correlate with Clinical Deterioration in Hospitalized Patients with Covid-19

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