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Usefulness of Easy-to-Use Risk Scoring Systems Rated in the Emergency Department to Predict Major Adverse Outcomes in Hospitalized COVID-19 Patients

Background: Several easy-to-use risk scoring systems have been built to identify patients at risk of developing complications associated with COVID-19. However, information about the ability of each score to early predict major adverse outcomes during hospitalization of severe COVID-19 patients is s...

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Autores principales: González-Flores, Julieta, García-Ávila, Carlos, Springall, Rashidi, Brianza-Padilla, Malinalli, Juárez-Vicuña, Yaneli, Márquez-Velasco, Ricardo, Sánchez-Muñoz, Fausto, Ballinas-Verdugo, Martha A., Basilio-Gálvez, Edna, Castillo-Salazar, Mauricio, Cásarez-Alvarado, Sergio, Hernández-Diazcouder, Adrián, Sánchez-Gloria, José L., Sandoval, Julio, González-Pacheco, Héctor, Tavera-Alonso, Claudia, Rojas-Velasco, Gustavo, Baranda-Tovar, Francisco, Amezcua-Guerra, Luis M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8397140/
https://www.ncbi.nlm.nih.gov/pubmed/34441957
http://dx.doi.org/10.3390/jcm10163657
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author González-Flores, Julieta
García-Ávila, Carlos
Springall, Rashidi
Brianza-Padilla, Malinalli
Juárez-Vicuña, Yaneli
Márquez-Velasco, Ricardo
Sánchez-Muñoz, Fausto
Ballinas-Verdugo, Martha A.
Basilio-Gálvez, Edna
Castillo-Salazar, Mauricio
Cásarez-Alvarado, Sergio
Hernández-Diazcouder, Adrián
Sánchez-Gloria, José L.
Sandoval, Julio
González-Pacheco, Héctor
Tavera-Alonso, Claudia
Rojas-Velasco, Gustavo
Baranda-Tovar, Francisco
Amezcua-Guerra, Luis M.
author_facet González-Flores, Julieta
García-Ávila, Carlos
Springall, Rashidi
Brianza-Padilla, Malinalli
Juárez-Vicuña, Yaneli
Márquez-Velasco, Ricardo
Sánchez-Muñoz, Fausto
Ballinas-Verdugo, Martha A.
Basilio-Gálvez, Edna
Castillo-Salazar, Mauricio
Cásarez-Alvarado, Sergio
Hernández-Diazcouder, Adrián
Sánchez-Gloria, José L.
Sandoval, Julio
González-Pacheco, Héctor
Tavera-Alonso, Claudia
Rojas-Velasco, Gustavo
Baranda-Tovar, Francisco
Amezcua-Guerra, Luis M.
author_sort González-Flores, Julieta
collection PubMed
description Background: Several easy-to-use risk scoring systems have been built to identify patients at risk of developing complications associated with COVID-19. However, information about the ability of each score to early predict major adverse outcomes during hospitalization of severe COVID-19 patients is still scarce. Methods: Eight risk scoring systems were rated upon arrival at the Emergency Department, and the occurrence of thrombosis, need for mechanical ventilation, death, and a composite that included all major adverse outcomes were assessed during the hospital stay. The clinical performance of each risk scoring system was evaluated to predict each major outcome. Finally, the diagnostic characteristics of the risk scoring system that showed the best performance for each major outcome were obtained. Results: One hundred and fifty-seven adult patients (55 ± 12 years, 66% men) were assessed at admission to the Emergency Department and included in the study. A total of 96 patients (61%) had at least one major outcome during hospitalization; 32 had thrombosis (20%), 80 required mechanical ventilation (50%), and 52 eventually died (33%). Of all the scores, Obesity and Diabetes (based on a history of comorbid conditions) showed the best performance for predicting mechanical ventilation (area under the ROC curve (AUC), 0.96; positive likelihood ratio (LR+), 23.7), death (AUC, 0.86; LR+, 4.6), and the composite outcome (AUC, 0.89; LR+, 15.6). Meanwhile, the inflammation-based risk scoring system (including leukocyte count, albumin, and C-reactive protein levels) was the best at predicting thrombosis (AUC, 0.63; LR+, 2.0). Conclusions: Both the Obesity and Diabetes score and the inflammation-based risk scoring system appeared to be efficient enough to be integrated into the evaluation of COVID-19 patients upon arrival at the Emergency Department.
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spelling pubmed-83971402021-08-28 Usefulness of Easy-to-Use Risk Scoring Systems Rated in the Emergency Department to Predict Major Adverse Outcomes in Hospitalized COVID-19 Patients González-Flores, Julieta García-Ávila, Carlos Springall, Rashidi Brianza-Padilla, Malinalli Juárez-Vicuña, Yaneli Márquez-Velasco, Ricardo Sánchez-Muñoz, Fausto Ballinas-Verdugo, Martha A. Basilio-Gálvez, Edna Castillo-Salazar, Mauricio Cásarez-Alvarado, Sergio Hernández-Diazcouder, Adrián Sánchez-Gloria, José L. Sandoval, Julio González-Pacheco, Héctor Tavera-Alonso, Claudia Rojas-Velasco, Gustavo Baranda-Tovar, Francisco Amezcua-Guerra, Luis M. J Clin Med Article Background: Several easy-to-use risk scoring systems have been built to identify patients at risk of developing complications associated with COVID-19. However, information about the ability of each score to early predict major adverse outcomes during hospitalization of severe COVID-19 patients is still scarce. Methods: Eight risk scoring systems were rated upon arrival at the Emergency Department, and the occurrence of thrombosis, need for mechanical ventilation, death, and a composite that included all major adverse outcomes were assessed during the hospital stay. The clinical performance of each risk scoring system was evaluated to predict each major outcome. Finally, the diagnostic characteristics of the risk scoring system that showed the best performance for each major outcome were obtained. Results: One hundred and fifty-seven adult patients (55 ± 12 years, 66% men) were assessed at admission to the Emergency Department and included in the study. A total of 96 patients (61%) had at least one major outcome during hospitalization; 32 had thrombosis (20%), 80 required mechanical ventilation (50%), and 52 eventually died (33%). Of all the scores, Obesity and Diabetes (based on a history of comorbid conditions) showed the best performance for predicting mechanical ventilation (area under the ROC curve (AUC), 0.96; positive likelihood ratio (LR+), 23.7), death (AUC, 0.86; LR+, 4.6), and the composite outcome (AUC, 0.89; LR+, 15.6). Meanwhile, the inflammation-based risk scoring system (including leukocyte count, albumin, and C-reactive protein levels) was the best at predicting thrombosis (AUC, 0.63; LR+, 2.0). Conclusions: Both the Obesity and Diabetes score and the inflammation-based risk scoring system appeared to be efficient enough to be integrated into the evaluation of COVID-19 patients upon arrival at the Emergency Department. MDPI 2021-08-18 /pmc/articles/PMC8397140/ /pubmed/34441957 http://dx.doi.org/10.3390/jcm10163657 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
González-Flores, Julieta
García-Ávila, Carlos
Springall, Rashidi
Brianza-Padilla, Malinalli
Juárez-Vicuña, Yaneli
Márquez-Velasco, Ricardo
Sánchez-Muñoz, Fausto
Ballinas-Verdugo, Martha A.
Basilio-Gálvez, Edna
Castillo-Salazar, Mauricio
Cásarez-Alvarado, Sergio
Hernández-Diazcouder, Adrián
Sánchez-Gloria, José L.
Sandoval, Julio
González-Pacheco, Héctor
Tavera-Alonso, Claudia
Rojas-Velasco, Gustavo
Baranda-Tovar, Francisco
Amezcua-Guerra, Luis M.
Usefulness of Easy-to-Use Risk Scoring Systems Rated in the Emergency Department to Predict Major Adverse Outcomes in Hospitalized COVID-19 Patients
title Usefulness of Easy-to-Use Risk Scoring Systems Rated in the Emergency Department to Predict Major Adverse Outcomes in Hospitalized COVID-19 Patients
title_full Usefulness of Easy-to-Use Risk Scoring Systems Rated in the Emergency Department to Predict Major Adverse Outcomes in Hospitalized COVID-19 Patients
title_fullStr Usefulness of Easy-to-Use Risk Scoring Systems Rated in the Emergency Department to Predict Major Adverse Outcomes in Hospitalized COVID-19 Patients
title_full_unstemmed Usefulness of Easy-to-Use Risk Scoring Systems Rated in the Emergency Department to Predict Major Adverse Outcomes in Hospitalized COVID-19 Patients
title_short Usefulness of Easy-to-Use Risk Scoring Systems Rated in the Emergency Department to Predict Major Adverse Outcomes in Hospitalized COVID-19 Patients
title_sort usefulness of easy-to-use risk scoring systems rated in the emergency department to predict major adverse outcomes in hospitalized covid-19 patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8397140/
https://www.ncbi.nlm.nih.gov/pubmed/34441957
http://dx.doi.org/10.3390/jcm10163657
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