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.
RESULTS: 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.
CONCLUSIONS: 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.
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.
RESULTS: 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.
CONCLUSIONS: 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.
摘要：
背景：肺炎和败血症的严重程度评分正应用于SARS-CoV-2感染。我们的目的是评估这些严重程度评分是否是COVID-19早期不良结局的准确预测因子。
方法：我们进行了一项住院SARS-CoV-2感染的多中心观察性研究。我们评估了风险评分(CURB65，qSOFA，Lac-CURB65，MuLBSTA和NEWS2）与入院后7天内接受重症监护或死亡有关，定义为早期严重不良事件（ESAE）。还在患者亚组中评估了4C死亡率评分。
结果：在2,387名参与者中，总死亡率为18%.在所有检查的分数中，评分增加与ESAE风险增加相关.曲线下面积(AUC)预测CURB65、qSOFA、Lac-CURB65、MuLBSTA和NEWS2分别为0.61、0.62、0.59、0.59和0.68。用ISARIC4C死亡率评分预测ESAE的AUC为0.60。
结论：在SARS-CoV-2感染中，没有一个被检查的分数能准确预测ESAE。未经验证的评分不应用于COVID-19的临床决策。
方法：我们进行了一项住院SARS-CoV-2感染的多中心观察性研究。我们评估了风险评分(CURB65，qSOFA，Lac-CURB65，MuLBSTA和NEWS2）与入院后7天内接受重症监护或死亡有关，定义为早期严重不良事件（ESAE）。还在患者亚组中评估了4C死亡率评分。
结果：在2,387名参与者中，总死亡率为18%.在所有检查的分数中，评分增加与ESAE风险增加相关.曲线下面积(AUC)预测CURB65、qSOFA、Lac-CURB65、MuLBSTA和NEWS2分别为0.61、0.62、0.59、0.59和0.68。用ISARIC4C死亡率评分预测ESAE的AUC为0.60。
结论：在SARS-CoV-2感染中，没有一个被检查的分数能准确预测ESAE。未经验证的评分不应用于COVID-19的临床决策。
