Evaluation of physiological severity scores for predicting COVID-19 disease progression: a retrospective study.

BACKGROUND

The coronavirus disease (COVID-19) pandemic indeed strains healthcare systems worldwide, resulting in a surge of patients with severe conditions. Numerous physiological severity scores have been assigned to assess critical conditions; however, a comprehensive comparison of these scoring systems remains lacking. Therefore, this study aimed to evaluate the performance of the severity scores upon admission in predicting the progression of COVID-19 patients to a severe condition within 14 days after hospitalization.

METHODS

Non-critically ill COVID-19 patients admitted to the Faculty of Medicine, Vajira Hospital, between 1 January 2021 and 30 June 2021, were assessed. We compared the discriminated ability of physiological severity scores in predicting disease progression to critical conditions using the area under the receiver operating characteristic curve (AUC).

RESULTS

Totally, 348 non-critically ill COVID-19 patients were included. Of these, 60 patients (17.2%) progressed to severe conditions within 14 days after hospitalization. The National Early Warning Score 2 with age and body mass index (NEWS2 Plus) was the most outperformed than the National Early Warning Score (NEWS), the National Early Warning Score 2 (NEWS2), the Hamilton Early Warning Score (HEWS), the Modified Early Warning Score (MEWS), and the quick Sepsis-related Organ Failure Assessment (qSOFA) scores, for predicting deterioration to severe conditions [AUC 0.77 (95% CI; 0.72-0.83)]. The NEWS2 Plus with a cutoff point of five exhibited high sensitivity (83.3%) and high negative predictive value (NPV) of 94.7%.

CONCLUSIONS

NEWS2 Plus score can enhance its utility for triage of COVID-19 patients' clinical status upon admission and guide appropriate management decisions for resource allocation.

TRIAL REGISTRATION

TCTR20241026001, registered on 26 October 2024.