Article Data

  • Views 2516
  • Dowloads 220

Original Research

Open Access

A new simple score to predict mortality of COVID-19 in the emergency department

  • Marcello Candelli1,*,
  • Giulia Pignataro1
  • Marta Sacco Fernandez1
  • Sara Cicchinelli1
  • Antonio Gullì1
  • Enrico Torelli1
  • Maurizio Gabrielli1
  • Andrea Piccioni1
  • Marcello Covino1
  • Veronica Ojetti1
  • Massimo Antonelli1
  • Antonio Gasbarrini2
  • Francesco Franceschi1

1Emergency, Anesthesiological and Reanimation Sciences Department, Fondazione Policlinico Universitario A. Gemelli-IRRCS-Catholic University of the Sacred Heart of Rome, 00168 Rome, Italy

2Medical and Surgical Sciences Department, Fondazione Policlinico Universitario A. Gemelli-IRRCS-Catholic University of the Sacred Heart of Rome, 00168 Rome, Italy

DOI: 10.22514/sv.2022.025 Vol.19,Issue 2,March 2023 pp.20-27

Submitted: 11 December 2021 Accepted: 16 February 2022

Published: 08 March 2023

*Corresponding Author(s): Marcello Candelli E-mail: marcello.candelli@policlinicogemelli.it

Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is one of the greatest challenges facing global medical research. The availability of a clinical score that can predict mortality risk at the time of diagnosis could be a valuable tool in the hands of emergency physicians to make clinical decisions. Our study is designed to evaluate clinical and laboratory endpoints associated with mortality and to determine a prognostic score based on clinical and laboratory variables. We retrospectively enrolled 367 patients diagnosed with coronavirus disease 19 (COVID-19) in our emergency department (ED). We evaluated their mortality 60 days after diagnosis. Symptoms, demographic data, concomitant diseases, and various laboratory parameters were obtained from all patients. Variables related to death were assessed using multiple logistic regression analysis. From these, we created a score called ANCOC (Age, blood urea Nitrogen, C-reactive protein, Oxygen saturation, Comorbidities). The area under the receiver operating characteristic (ROC) curve was calculated for the ANCOC and for the 4C score. The 4C score has been described and validated in previous works and can predict mortality in COVID-19 patients. We compared the 2 scores and analysed sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for 60-day mortality for the ANCOC score. The ANCOC and 4C scores accurately predicted death from COVID-19. There were no differences in accuracy between the scores. An ANCOC score <–1 identified patients who will recover with a PPV and sensitivity of 100%, whereas a score >3 identified patients at high risk of death. The ANCOC score has very high diagnostic accuracy in predicting the risk of death in patients with COVID-19 diagnosed at ED. The ANCOC score has similar accuracy to the 4C score but is easier to calculate. If validated by external cohorts, this score could be an additional tool in the hands of ED physicians to identify COVID-19 patients at high risk of death.


Keywords

COVID-19; Prognostic score; Comorbidity; SARS-CoV-2; Mortality


Cite and Share

Marcello Candelli,Giulia Pignataro,Marta Sacco Fernandez,Sara Cicchinelli,Antonio Gullì,Enrico Torelli,Maurizio Gabrielli,Andrea Piccioni,Marcello Covino,Veronica Ojetti,Massimo Antonelli,Antonio Gasbarrini,Francesco Franceschi. A new simple score to predict mortality of COVID-19 in the emergency department. Signa Vitae. 2023. 19(2);20-27.

References

[1] Polack FP, Thomas SJ, Kitchin N, Absalon J, Gurtman A, Lockhart S, et al. Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. New England Journal of Medicine. 2020; 383: 2603–2615.

[2] Baden LR, El Sahly HM, Essink B, Kotloff K, Frey S, Novak R, et al. Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. New England Journal of Medicine. 2021; 384: 403–416.

[3] Madhi SA, Baillie V, Cutland CL, Voysey M, Koen AL, Fairlie L, et al. Efficacy of the ChAdOx1 nCoV-19 Covid-19 vaccine against the B.1.351 variant. New England Journal of Medicine. 2021; 384: 1885–1898.

[4] Sadoff J, Gray G, Vandebosch A, Cárdenas V, Shukarev G, Grinsztejn B, et al. Safety and efficacy of single-dose Ad26.COV2.S vaccine against Covid-19. New England Journal of Medicine. 2021; 384: 2187–2201.

[5] Knight SR, Ho A, Pius R, Buchan I, Carson G, Drake TM, et al. Risk stratification of patients admitted to hospital with Covid-19 using the ISARIC WHO clinical characterisation protocol: development and validation of the 4C mortality score. The BMJ. 2020; 371: m3339.

[6] Lazar Neto F, Marino LO, Torres A, Cilloniz C, Meirelles Marchini JF, Garcia de Alencar JC, et al. Community-acquired pneumonia severity assessment tools in patients hospitalized with COVID-19: a validation and clinical applicability study. Clinical Microbiology and Infection. 2021; 27: 1037.e1–1037.e8.

[7] Maurya SK, Bhattacharya A, Shukla P, Mishra R. Insights on epi-demiology, pathogenesis, diagnosis and possible treatment of COVID-19 infection. Proceedings of the National Academy of Sciences, India Section B: Biological Sciences. 2022; 1–9.

[8] Tazerji SS, Shahabinejad F, Tokasi M, Rad MA, Khan MS, Safdar M, et al. Global data analysis and risk factors associated with morbidity and mortality of COVID-19. Gene Reports. 2022; 26: 101505.

[9] Barda N, Dagan N, Cohen C, Hernán MA, Lipsitch M, Kohane IS, et al. Effectiveness of a third dose of the BNT162b2 mRNA COVID-19 vaccine for preventing severe outcomes in Israel: an observational study. The Lancet. 2021; 398: 2093–2100.

[10] Robinson E, Jones A, Daly M. International estimates of intended uptake and refusal of COVID-19 vaccines: a rapid systematic review and meta-analysis of large nationally representative samples. Vaccine. 2021; 39: 2024–2034.

[11] Mahase E. Covid-19: molnupiravir reduces risk of hospital admission or death by 50% in patients at risk, MSD reports. The BMJ. 2021; 375: n2422.


Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

Index Copernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus: CiteScore 1.3 (2023) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time

Conferences

Top