Risk of Seven-Day Worsening and Death: A New Clinically Derived COVID-19 Score
This monocentric, retrospective, two-stage observational study aimed to recognize the risk factors for a poor outcome in patients hospitalized with SARS-CoV-2 infection, and to develop and validate a risk score that identifies subjects at risk of worsening, death, or both. The data of patients with...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-03-01
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| Series: | Viruses |
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| Online Access: | https://www.mdpi.com/1999-4915/14/3/642 |
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| author | Alessia Cruciata Lorenzo Volpicelli Silvia Di Bari Giancarlo Iaiani Bruno Cirillo Francesco Pugliese Daniela Pellegrino Gioacchino Galardo Gloria Taliani |
| author_facet | Alessia Cruciata Lorenzo Volpicelli Silvia Di Bari Giancarlo Iaiani Bruno Cirillo Francesco Pugliese Daniela Pellegrino Gioacchino Galardo Gloria Taliani |
| author_sort | Alessia Cruciata |
| collection | DOAJ |
| description | This monocentric, retrospective, two-stage observational study aimed to recognize the risk factors for a poor outcome in patients hospitalized with SARS-CoV-2 infection, and to develop and validate a risk score that identifies subjects at risk of worsening, death, or both. The data of patients with SARS-CoV-2 infection during the first wave of the pandemic were collected and analyzed as a derivation cohort. Variables with predictive properties were used to construct a prognostic score, which was tried out on a validation cohort enrolled during the second wave. The derivation cohort included 494 patients; the median age was 62 and the overall fatality rate was 22.3%. In a multivariable analysis, age, oxygen saturation, neutrophil-to-lymphocyte ratio, C-reactive protein and lactate dehydrogenase were independent predictors of death and composed the score. A cutoff value of 3 demonstrated a sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) of 93.5%, 68.5%, 47.4% and 97.2% for death, and 84.9%, 84.5%, 79.6% and 87.9% for worsening, respectively. The validation cohort included 415 subjects. The score application showed a Se, Sp, PPV and NPV of 93.4%, 61.6%, 29.5% and 98.1% for death, and 81%, 76.3%, 72.1% and 84.1% for worsening, respectively. We propose a new clinical, easy and reliable score to predict the outcome in hospitalized SARS-CoV-2 patients. |
| first_indexed | 2024-03-09T12:15:12Z |
| format | Article |
| id | doaj.art-c2055256570d49ea8cce74ef224aefe1 |
| institution | Directory Open Access Journal |
| issn | 1999-4915 |
| language | English |
| last_indexed | 2024-03-09T12:15:12Z |
| publishDate | 2022-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Viruses |
| spelling | doaj.art-c2055256570d49ea8cce74ef224aefe12023-11-30T22:47:31ZengMDPI AGViruses1999-49152022-03-0114364210.3390/v14030642Risk of Seven-Day Worsening and Death: A New Clinically Derived COVID-19 ScoreAlessia Cruciata0Lorenzo Volpicelli1Silvia Di Bari2Giancarlo Iaiani3Bruno Cirillo4Francesco Pugliese5Daniela Pellegrino6Gioacchino Galardo7Gloria Taliani8Infectious and Tropical Medicine Unit, Department of Public Health and Infectious Diseases, “Policlinico Umberto I” Hospital, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, ItalyInfectious and Tropical Medicine Unit, Department of Public Health and Infectious Diseases, “Policlinico Umberto I” Hospital, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, ItalyInfectious and Tropical Medicine Unit, Department of Public Health and Infectious Diseases, “Policlinico Umberto I” Hospital, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, ItalyInfectious and Tropical Medicine Unit, Department of Public Health and Infectious Diseases, “Policlinico Umberto I” Hospital, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, ItalyDepartment of Surgery “Pietro Valdoni”, “Policlinico Umberto I” Hospital, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, ItalyDepartment of General Surgery and Surgical Specialities “Paride Stefanini”, “Policlinico Umberto I” Hospital, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, ItalyPulmonology, Respiratory and Critical Care Unit, Department of Public Health and Infectious Diseases, “Policlinico Umberto I” Hospital, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, ItalyMedical Emergency Unit, Department of Emergency, “Policlinico Umberto I” Hospital, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, ItalyInfectious and Tropical Medicine Unit, Department of Public Health and Infectious Diseases, “Policlinico Umberto I” Hospital, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, ItalyThis monocentric, retrospective, two-stage observational study aimed to recognize the risk factors for a poor outcome in patients hospitalized with SARS-CoV-2 infection, and to develop and validate a risk score that identifies subjects at risk of worsening, death, or both. The data of patients with SARS-CoV-2 infection during the first wave of the pandemic were collected and analyzed as a derivation cohort. Variables with predictive properties were used to construct a prognostic score, which was tried out on a validation cohort enrolled during the second wave. The derivation cohort included 494 patients; the median age was 62 and the overall fatality rate was 22.3%. In a multivariable analysis, age, oxygen saturation, neutrophil-to-lymphocyte ratio, C-reactive protein and lactate dehydrogenase were independent predictors of death and composed the score. A cutoff value of 3 demonstrated a sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) of 93.5%, 68.5%, 47.4% and 97.2% for death, and 84.9%, 84.5%, 79.6% and 87.9% for worsening, respectively. The validation cohort included 415 subjects. The score application showed a Se, Sp, PPV and NPV of 93.4%, 61.6%, 29.5% and 98.1% for death, and 81%, 76.3%, 72.1% and 84.1% for worsening, respectively. We propose a new clinical, easy and reliable score to predict the outcome in hospitalized SARS-CoV-2 patients.https://www.mdpi.com/1999-4915/14/3/642SARS-CoV-2COVID-19risk of deathrisk of worseningclinical scoreprognostic score |
| spellingShingle | Alessia Cruciata Lorenzo Volpicelli Silvia Di Bari Giancarlo Iaiani Bruno Cirillo Francesco Pugliese Daniela Pellegrino Gioacchino Galardo Gloria Taliani Risk of Seven-Day Worsening and Death: A New Clinically Derived COVID-19 Score Viruses SARS-CoV-2 COVID-19 risk of death risk of worsening clinical score prognostic score |
| title | Risk of Seven-Day Worsening and Death: A New Clinically Derived COVID-19 Score |
| title_full | Risk of Seven-Day Worsening and Death: A New Clinically Derived COVID-19 Score |
| title_fullStr | Risk of Seven-Day Worsening and Death: A New Clinically Derived COVID-19 Score |
| title_full_unstemmed | Risk of Seven-Day Worsening and Death: A New Clinically Derived COVID-19 Score |
| title_short | Risk of Seven-Day Worsening and Death: A New Clinically Derived COVID-19 Score |
| title_sort | risk of seven day worsening and death a new clinically derived covid 19 score |
| topic | SARS-CoV-2 COVID-19 risk of death risk of worsening clinical score prognostic score |
| url | https://www.mdpi.com/1999-4915/14/3/642 |
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