Utility of early warning scores to predict mortality in COVID-19 patients: A retrospective observational study.

BACKGROUND

Coronavirus disease 2019 (COVID19) has evolved as a global pandemic. The patients with COVID-19 infection can present as mild, moderate, and severe disease forms. The reported mortality of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection is around 6.6%, which is lower than that of SARS-CoV and (middle east respiratory syndrome CoV). However, the fatality rate of COVID-19 infection is higher in the geriatric age group and in patients with multiple co-morbidities. The study aimed to evaluate the utility of early warning scores (EWS) to predict mortality in patients with moderate to severe COVID-19 infection.

METHODS

This retrospective study was carried out in a tertiary care institute of Uttarakhand. Demographic and clinical data of the admitted patients with moderate-to-severe COVID-19 infection were collected from the hospital record section and utilized to calculate the EWS-National early warning score (NEWS), modified early warning score (MEWS), Rapid Acute Physiology Score (RAPS), rapid emergency medicine score (REMS), and worthing physiological scoring system (WPS).

RESULTS

The area under the curve for NEWS, MEWS, RAPS, REMS, and WPS was 0.813 (95% confidence interval [CI]; 0.769-0.858), 0.770 (95% CI; 0.717-0.822), 0.755 (95% CI; 0.705-0.805), 0.892 (95% CI; 0.859-0.924), and 0.892 (95% CI; 0.86-0.924), respectively.

CONCLUSION

The EWS at triage can be used for early assessment of severity as well as predict mortality in patients with COVID-19 patients.