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.
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。