Utility of severity assessment tools in COVID-19 pneumonia: a multicentre observational study

Asim Ahmed; Sayed A Alderazi; Rumaisa Aslam; Barooq Barkat; Bethan L Barker; Rahul Bhat; Samuel Cassidy; Louise E Crowley; Davinder Ps Dosanjh; Hussain Ebrahim; Najla Elndari; Claudia Gardiner; Atena Gogokhia; Frances S Grudzinska; Megha T Gurung; Terry Hughes; Iyad Ismail; Natasha Iredale; Sannaan Irshad; Sarah Johnson; Diana Kavanagh; Thomas Knight; Alana Livesey; Sebastian T Lugg; Manoj Marathe; Andrew Mcdougall; Wasim Nawaz; Kimberly Nettleton; Lauren O’flynn; Kelvin Okoth; Dhruv Parekh; Rita Perry; Elizabeth J Pudney; Ambreen Sadiq; Olutobi Soge; Rhania Soloman; Marina Soltan; Martin Strecker; Onn S Thein; David Thickett; Ajit Thomas; Riah Thornton

doi:10.7861/clinmed.2020-1107

Utility of severity assessment tools in COVID-19 pneumonia: a multicentre observational study

Asim Ahmed
, Sayed A Alderazi
, Rumaisa Aslam
, Barooq Barkat
, Bethan L Barker
, Rahul Bhat
, Samuel Cassidy
, Louise E Crowley
, Davinder Ps Dosanjh
, Hussain Ebrahim
, Najla Elndari
, Claudia Gardiner
, Atena Gogokhia
, Frances S Grudzinska
, Megha T Gurung
, Terry Hughes
, Iyad Ismail
, Natasha Iredale
, Sannaan Irshad
, Sarah Johnson

Diana Kavanagh, Thomas Knight, Alana Livesey, Sebastian T Lugg, Manoj Marathe, Andrew Mcdougall, Wasim Nawaz, Kimberly Nettleton, Lauren O’flynn, Kelvin Okoth, Dhruv Parekh, Rita Perry, Elizabeth J Pudney, Ambreen Sadiq, Olutobi Soge, Rhania Soloman, Marina Soltan, Martin Strecker, Onn S Thein, David Thickett, Ajit Thomas, Riah Thornton

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Severity scores in pneumonia and sepsis are being applied to SARS-CoV-2 infection. We aimed to assess whether these severity scores are accurate predictors of early adverse outcomes in COVID-19.

Methods: We conducted a multicentre observational study of hospitalised SARS-CoV-2 infection. We assessed risk scores (CURB65, qSOFA, Lac-CURB65, MuLBSTA and NEWS2) in relation to admission to intensive care or death within 7 days of admission, defined as early severe adverse events (ESAE). The 4C Mortality Score was also assessed in a sub-cohort of patients.

Findings: In 2,387 participants, the overall mortality was 18%. In all scores examined, increasing score was associated with increased risk of ESAE. Area under the curve (AUC) to predict ESAE for CURB65, qSOFA, Lac-CURB65, MuLBSTA and NEWS2 were 0.61, 0.62, 0.59, 0.59 and 0.68, respectively. AUC to predict ESAE was 0.60 with ISARIC 4C Mortality Score.

Conclusion: None of the scores examined accurately predicted ESAE in SARS-CoV-2 infection. Non-validated scores should not be used to inform clinical decision making in COVID-19.

Original language	English
Pages (from-to)	63-70
Number of pages	8
Journal	Clinical Medicine
Volume	22
Issue number	1
DOIs	https://doi.org/10.7861/clinmed.2020-1107
Publication status	Published - 25 Jan 2022

Keywords

COVID-19
pneumonia
severity score
collaborative

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Ahmed, A., Alderazi, S. A., Aslam, R., Barkat, B., Barker, B. L., Bhat, R., Cassidy, S., Crowley, L. E., Dosanjh, D. P., Ebrahim, H., Elndari, N., Gardiner, C., Gogokhia, A., Grudzinska, F. S., Gurung, M. T., Hughes, T., Ismail, I., Iredale, N., Irshad, S., ... Thornton, R. (2022). Utility of severity assessment tools in COVID-19 pneumonia: a multicentre observational study. Clinical Medicine, 22(1), 63-70. https://doi.org/10.7861/clinmed.2020-1107

@article{11581631d58043098ac682b520b16a96,

title = "Utility of severity assessment tools in COVID-19 pneumonia: a multicentre observational study",

abstract = "Background: Severity scores in pneumonia and sepsis are being applied to SARS-CoV-2 infection. We aimed to assess whether these severity scores are accurate predictors of early adverse outcomes in COVID-19. Methods: We conducted a multicentre observational study of hospitalised SARS-CoV-2 infection. We assessed risk scores (CURB65, qSOFA, Lac-CURB65, MuLBSTA and NEWS2) in relation to admission to intensive care or death within 7 days of admission, defined as early severe adverse events (ESAE). The 4C Mortality Score was also assessed in a sub-cohort of patients. Findings: In 2,387 participants, the overall mortality was 18\%. In all scores examined, increasing score was associated with increased risk of ESAE. Area under the curve (AUC) to predict ESAE for CURB65, qSOFA, Lac-CURB65, MuLBSTA and NEWS2 were 0.61, 0.62, 0.59, 0.59 and 0.68, respectively. AUC to predict ESAE was 0.60 with ISARIC 4C Mortality Score. Conclusion: None of the scores examined accurately predicted ESAE in SARS-CoV-2 infection. Non-validated scores should not be used to inform clinical decision making in COVID-19.",

keywords = "COVID-19, pneumonia, severity score, collaborative",

author = "Asim Ahmed and Alderazi, \{Sayed A\} and Rumaisa Aslam and Barooq Barkat and Barker, \{Bethan L\} and Rahul Bhat and Samuel Cassidy and Crowley, \{Louise E\} and Dosanjh, \{Davinder Ps\} and Hussain Ebrahim and Najla Elndari and Claudia Gardiner and Atena Gogokhia and Grudzinska, \{Frances S\} and Gurung, \{Megha T\} and Terry Hughes and Iyad Ismail and Natasha Iredale and Sannaan Irshad and Sarah Johnson and Diana Kavanagh and Thomas Knight and Alana Livesey and Lugg, \{Sebastian T\} and Manoj Marathe and Andrew Mcdougall and Wasim Nawaz and Kimberly Nettleton and Lauren O{\textquoteright}flynn and Kelvin Okoth and Dhruv Parekh and Rita Perry and Pudney, \{Elizabeth J\} and Ambreen Sadiq and Olutobi Soge and Rhania Soloman and Marina Soltan and Martin Strecker and Thein, \{Onn S\} and David Thickett and Ajit Thomas and Riah Thornton",

year = "2022",

month = jan,

day = "25",

doi = "10.7861/clinmed.2020-1107",

language = "English",

volume = "22",

pages = "63--70",

journal = "Clinical Medicine",

issn = "1470-2118",

publisher = "Royal College of Physicians",

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Ahmed, A, Alderazi, SA, Aslam, R, Barkat, B, Barker, BL, Bhat, R, Cassidy, S, Crowley, LE, Dosanjh, DP, Ebrahim, H, Elndari, N, Gardiner, C, Gogokhia, A, Grudzinska, FS, Gurung, MT, Hughes, T, Ismail, I, Iredale, N, Irshad, S, Johnson, S, Kavanagh, D, Knight, T, Livesey, A, Lugg, ST, Marathe, M, Mcdougall, A, Nawaz, W, Nettleton, K, O’flynn, L, Okoth, K, Parekh, D , Perry, R, Pudney, EJ, Sadiq, A, Soge, O, Soloman, R, Soltan, M, Strecker, M, Thein, OS, Thickett, D, Thomas, A & Thornton, R 2022, 'Utility of severity assessment tools in COVID-19 pneumonia: a multicentre observational study', Clinical Medicine, vol. 22, no. 1, pp. 63-70. https://doi.org/10.7861/clinmed.2020-1107

TY - JOUR

T1 - Utility of severity assessment tools in COVID-19 pneumonia

T2 - a multicentre observational study

AU - Ahmed, Asim

AU - Alderazi, Sayed A

AU - Aslam, Rumaisa

AU - Barkat, Barooq

AU - Barker, Bethan L

AU - Bhat, Rahul

AU - Cassidy, Samuel

AU - Crowley, Louise E

AU - Dosanjh, Davinder Ps

AU - Ebrahim, Hussain

AU - Elndari, Najla

AU - Gardiner, Claudia

AU - Gogokhia, Atena

AU - Grudzinska, Frances S

AU - Gurung, Megha T

AU - Hughes, Terry

AU - Ismail, Iyad

AU - Iredale, Natasha

AU - Irshad, Sannaan

AU - Johnson, Sarah

AU - Kavanagh, Diana

AU - Knight, Thomas

AU - Livesey, Alana

AU - Lugg, Sebastian T

AU - Marathe, Manoj

AU - Mcdougall, Andrew

AU - Nawaz, Wasim

AU - Nettleton, Kimberly

AU - O’flynn, Lauren

AU - Okoth, Kelvin

AU - Parekh, Dhruv

AU - Perry, Rita

AU - Pudney, Elizabeth J

AU - Sadiq, Ambreen

AU - Soge, Olutobi

AU - Soloman, Rhania

AU - Soltan, Marina

AU - Strecker, Martin

AU - Thein, Onn S

AU - Thickett, David

AU - Thomas, Ajit

AU - Thornton, Riah

PY - 2022/1/25

Y1 - 2022/1/25

N2 - Background: Severity scores in pneumonia and sepsis are being applied to SARS-CoV-2 infection. We aimed to assess whether these severity scores are accurate predictors of early adverse outcomes in COVID-19. Methods: We conducted a multicentre observational study of hospitalised SARS-CoV-2 infection. We assessed risk scores (CURB65, qSOFA, Lac-CURB65, MuLBSTA and NEWS2) in relation to admission to intensive care or death within 7 days of admission, defined as early severe adverse events (ESAE). The 4C Mortality Score was also assessed in a sub-cohort of patients. Findings: In 2,387 participants, the overall mortality was 18%. In all scores examined, increasing score was associated with increased risk of ESAE. Area under the curve (AUC) to predict ESAE for CURB65, qSOFA, Lac-CURB65, MuLBSTA and NEWS2 were 0.61, 0.62, 0.59, 0.59 and 0.68, respectively. AUC to predict ESAE was 0.60 with ISARIC 4C Mortality Score. Conclusion: None of the scores examined accurately predicted ESAE in SARS-CoV-2 infection. Non-validated scores should not be used to inform clinical decision making in COVID-19.

AB - Background: Severity scores in pneumonia and sepsis are being applied to SARS-CoV-2 infection. We aimed to assess whether these severity scores are accurate predictors of early adverse outcomes in COVID-19. Methods: We conducted a multicentre observational study of hospitalised SARS-CoV-2 infection. We assessed risk scores (CURB65, qSOFA, Lac-CURB65, MuLBSTA and NEWS2) in relation to admission to intensive care or death within 7 days of admission, defined as early severe adverse events (ESAE). The 4C Mortality Score was also assessed in a sub-cohort of patients. Findings: In 2,387 participants, the overall mortality was 18%. In all scores examined, increasing score was associated with increased risk of ESAE. Area under the curve (AUC) to predict ESAE for CURB65, qSOFA, Lac-CURB65, MuLBSTA and NEWS2 were 0.61, 0.62, 0.59, 0.59 and 0.68, respectively. AUC to predict ESAE was 0.60 with ISARIC 4C Mortality Score. Conclusion: None of the scores examined accurately predicted ESAE in SARS-CoV-2 infection. Non-validated scores should not be used to inform clinical decision making in COVID-19.

KW - COVID-19

KW - pneumonia

KW - severity score

KW - collaborative

UR - http://europepmc.org/abstract/med/35078796

U2 - 10.7861/clinmed.2020-1107

DO - 10.7861/clinmed.2020-1107

M3 - Article

C2 - 35078796

SN - 1470-2118

VL - 22

SP - 63

EP - 70

JO - Clinical Medicine

JF - Clinical Medicine

IS - 1

ER -

Utility of severity assessment tools in COVID-19 pneumonia: a multicentre observational study

Abstract

Keywords

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