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Discriminatory accuracy of the SOFA score for determining clinical decompensation in patients presenting with COVID-19

INTRODUCTION: While the global dissemination of vaccines targeting the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in a decline in the incidence of infections, the case fatality rates have remained relative stable. A major objective of managing hospitalized patients wit...

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Autores principales: Krepostman, N, Collins, M, Merchant, K, De Sirkar, S, Chan, L, Allen, S, Newman, J, Patel, D, Fareed, J, Berg, S, Darki, A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8767580/
http://dx.doi.org/10.1093/eurheartj/ehab724.2492
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author Krepostman, N
Collins, M
Merchant, K
De Sirkar, S
Chan, L
Allen, S
Newman, J
Patel, D
Fareed, J
Berg, S
Darki, A
author_facet Krepostman, N
Collins, M
Merchant, K
De Sirkar, S
Chan, L
Allen, S
Newman, J
Patel, D
Fareed, J
Berg, S
Darki, A
author_sort Krepostman, N
collection PubMed
description INTRODUCTION: While the global dissemination of vaccines targeting the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in a decline in the incidence of infections, the case fatality rates have remained relative stable. A major objective of managing hospitalized patients with documented or suspected COVID-19 infection is the rapid identification of features associated with severe illness using readily available laboratory tests and clinical tools. The sequential organ failure assessment (SOFA) score is a validated tool to facilitate the identification of patients at risk of dying from sepsis. PURPOSE: The aim of this study was to assess the discriminatory accuracy of the SOFA score in predicting clinical decompensation in patients hospitalized with COVID-19 infection. METHODS: We conducted a retrospective analysis at a three-hospital health system, comprised of one tertiary and two community hospitals, located in the Chicago metropolitan area. All patients had positive SARS-CoV-2 testing and were hospitalized for COVID-19 infection. The primary outcome was clinical decompensation, defined as the composite endpoint of death, ICU admission, or need for intubation. We utilized the most abnormal laboratory values observed during the admission to calculate the SOFA score. Receiver Operating Curves (ROC) were then constructed to determine the sensitivity and specificity of SOFA scores. RESULTS: Between March 1st and May 31st 2020, 1029 patients were included in our analysis with 367 patients meeting the study endpoint. The median SOFA score was 2.0 IQR (Q1, Q3 1,4) for the entire cohort. Patients who had in-hospital mortality had a median SOFA score of 4.0 (Q1,Q3 3,7). In patients that met the primary composite endpoint, the median SOFA score was 3.0, IQR (Q1, Q3 2,6). The ROC was 0.776 (95% CI 0.746–0.806, p<0.01). CONCLUSION: The SOFA score demonstrates strong discriminatory accuracy for prediction of clinical decompensation in patients presenting with COVID-19 at our urban hospital system. FUNDING ACKNOWLEDGEMENT: Type of funding sources: Public hospital(s). Main funding source(s): Loyola University Medical Center
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spelling pubmed-87675802022-01-20 Discriminatory accuracy of the SOFA score for determining clinical decompensation in patients presenting with COVID-19 Krepostman, N Collins, M Merchant, K De Sirkar, S Chan, L Allen, S Newman, J Patel, D Fareed, J Berg, S Darki, A Eur Heart J Abstract Supplement INTRODUCTION: While the global dissemination of vaccines targeting the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in a decline in the incidence of infections, the case fatality rates have remained relative stable. A major objective of managing hospitalized patients with documented or suspected COVID-19 infection is the rapid identification of features associated with severe illness using readily available laboratory tests and clinical tools. The sequential organ failure assessment (SOFA) score is a validated tool to facilitate the identification of patients at risk of dying from sepsis. PURPOSE: The aim of this study was to assess the discriminatory accuracy of the SOFA score in predicting clinical decompensation in patients hospitalized with COVID-19 infection. METHODS: We conducted a retrospective analysis at a three-hospital health system, comprised of one tertiary and two community hospitals, located in the Chicago metropolitan area. All patients had positive SARS-CoV-2 testing and were hospitalized for COVID-19 infection. The primary outcome was clinical decompensation, defined as the composite endpoint of death, ICU admission, or need for intubation. We utilized the most abnormal laboratory values observed during the admission to calculate the SOFA score. Receiver Operating Curves (ROC) were then constructed to determine the sensitivity and specificity of SOFA scores. RESULTS: Between March 1st and May 31st 2020, 1029 patients were included in our analysis with 367 patients meeting the study endpoint. The median SOFA score was 2.0 IQR (Q1, Q3 1,4) for the entire cohort. Patients who had in-hospital mortality had a median SOFA score of 4.0 (Q1,Q3 3,7). In patients that met the primary composite endpoint, the median SOFA score was 3.0, IQR (Q1, Q3 2,6). The ROC was 0.776 (95% CI 0.746–0.806, p<0.01). CONCLUSION: The SOFA score demonstrates strong discriminatory accuracy for prediction of clinical decompensation in patients presenting with COVID-19 at our urban hospital system. FUNDING ACKNOWLEDGEMENT: Type of funding sources: Public hospital(s). Main funding source(s): Loyola University Medical Center Oxford University Press 2021-10-14 /pmc/articles/PMC8767580/ http://dx.doi.org/10.1093/eurheartj/ehab724.2492 Text en Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions, please email: journals.permissions@oup.com. https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_modelThis article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model) This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.
spellingShingle Abstract Supplement
Krepostman, N
Collins, M
Merchant, K
De Sirkar, S
Chan, L
Allen, S
Newman, J
Patel, D
Fareed, J
Berg, S
Darki, A
Discriminatory accuracy of the SOFA score for determining clinical decompensation in patients presenting with COVID-19
title Discriminatory accuracy of the SOFA score for determining clinical decompensation in patients presenting with COVID-19
title_full Discriminatory accuracy of the SOFA score for determining clinical decompensation in patients presenting with COVID-19
title_fullStr Discriminatory accuracy of the SOFA score for determining clinical decompensation in patients presenting with COVID-19
title_full_unstemmed Discriminatory accuracy of the SOFA score for determining clinical decompensation in patients presenting with COVID-19
title_short Discriminatory accuracy of the SOFA score for determining clinical decompensation in patients presenting with COVID-19
title_sort discriminatory accuracy of the sofa score for determining clinical decompensation in patients presenting with covid-19
topic Abstract Supplement
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8767580/
http://dx.doi.org/10.1093/eurheartj/ehab724.2492
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