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External Validation of COVID-19 Risk Scores during Three Waves of Pandemic in a German Cohort—A Retrospective Study

Several risk scores were developed during the COVID-19 pandemic to identify patients at risk for critical illness as a basic step to personalizing medicine even in pandemic circumstances. However, the generalizability of these scores with regard to different populations, clinical settings, healthcar...

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Autores principales: Häger, Lukas, Wendland, Philipp, Biergans, Stephanie, Lederer, Simone, de Arruda Botelho Herr, Marius, Erhardt, Christian, Schmauder, Kristina, Kschischo, Maik, Malek, Nisar Peter, Bunk, Stefanie, Bitzer, Michael, Gladstone, Beryl Primrose, Göpel, Siri
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9693591/
https://www.ncbi.nlm.nih.gov/pubmed/36579493
http://dx.doi.org/10.3390/jpm12111775
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author Häger, Lukas
Wendland, Philipp
Biergans, Stephanie
Lederer, Simone
de Arruda Botelho Herr, Marius
Erhardt, Christian
Schmauder, Kristina
Kschischo, Maik
Malek, Nisar Peter
Bunk, Stefanie
Bitzer, Michael
Gladstone, Beryl Primrose
Göpel, Siri
author_facet Häger, Lukas
Wendland, Philipp
Biergans, Stephanie
Lederer, Simone
de Arruda Botelho Herr, Marius
Erhardt, Christian
Schmauder, Kristina
Kschischo, Maik
Malek, Nisar Peter
Bunk, Stefanie
Bitzer, Michael
Gladstone, Beryl Primrose
Göpel, Siri
author_sort Häger, Lukas
collection PubMed
description Several risk scores were developed during the COVID-19 pandemic to identify patients at risk for critical illness as a basic step to personalizing medicine even in pandemic circumstances. However, the generalizability of these scores with regard to different populations, clinical settings, healthcare systems, and new epidemiological circumstances is unknown. The aim of our study was to compare the predictive validity of qSOFA, CRB65, NEWS, COVID-GRAM, and 4C-Mortality score. In a monocentric retrospective cohort, consecutively hospitalized adults with COVID-19 from February 2020 to June 2021 were included; risk scores at admission were calculated. The area under the receiver operating characteristic curve and the area under the precision–recall curve were compared using DeLong’s method and a bootstrapping approach. A total of 347 patients were included; 23.6% were admitted to the ICU, and 9.2% died in a hospital. NEWS and 4C-Score performed best for the outcomes ICU admission and in-hospital mortality. The easy-to-use bedside score NEWS has proven to identify patients at risk for critical illness, whereas the more complex COVID-19-specific scores 4C and COVID-GRAM were not superior. Decreasing mortality and ICU-admission rates affected the discriminatory ability of all scores. A further evaluation of risk assessment is needed in view of new and rapidly changing epidemiological evolution.
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spelling pubmed-96935912022-11-26 External Validation of COVID-19 Risk Scores during Three Waves of Pandemic in a German Cohort—A Retrospective Study Häger, Lukas Wendland, Philipp Biergans, Stephanie Lederer, Simone de Arruda Botelho Herr, Marius Erhardt, Christian Schmauder, Kristina Kschischo, Maik Malek, Nisar Peter Bunk, Stefanie Bitzer, Michael Gladstone, Beryl Primrose Göpel, Siri J Pers Med Article Several risk scores were developed during the COVID-19 pandemic to identify patients at risk for critical illness as a basic step to personalizing medicine even in pandemic circumstances. However, the generalizability of these scores with regard to different populations, clinical settings, healthcare systems, and new epidemiological circumstances is unknown. The aim of our study was to compare the predictive validity of qSOFA, CRB65, NEWS, COVID-GRAM, and 4C-Mortality score. In a monocentric retrospective cohort, consecutively hospitalized adults with COVID-19 from February 2020 to June 2021 were included; risk scores at admission were calculated. The area under the receiver operating characteristic curve and the area under the precision–recall curve were compared using DeLong’s method and a bootstrapping approach. A total of 347 patients were included; 23.6% were admitted to the ICU, and 9.2% died in a hospital. NEWS and 4C-Score performed best for the outcomes ICU admission and in-hospital mortality. The easy-to-use bedside score NEWS has proven to identify patients at risk for critical illness, whereas the more complex COVID-19-specific scores 4C and COVID-GRAM were not superior. Decreasing mortality and ICU-admission rates affected the discriminatory ability of all scores. A further evaluation of risk assessment is needed in view of new and rapidly changing epidemiological evolution. MDPI 2022-10-28 /pmc/articles/PMC9693591/ /pubmed/36579493 http://dx.doi.org/10.3390/jpm12111775 Text en © 2022 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
Häger, Lukas
Wendland, Philipp
Biergans, Stephanie
Lederer, Simone
de Arruda Botelho Herr, Marius
Erhardt, Christian
Schmauder, Kristina
Kschischo, Maik
Malek, Nisar Peter
Bunk, Stefanie
Bitzer, Michael
Gladstone, Beryl Primrose
Göpel, Siri
External Validation of COVID-19 Risk Scores during Three Waves of Pandemic in a German Cohort—A Retrospective Study
title External Validation of COVID-19 Risk Scores during Three Waves of Pandemic in a German Cohort—A Retrospective Study
title_full External Validation of COVID-19 Risk Scores during Three Waves of Pandemic in a German Cohort—A Retrospective Study
title_fullStr External Validation of COVID-19 Risk Scores during Three Waves of Pandemic in a German Cohort—A Retrospective Study
title_full_unstemmed External Validation of COVID-19 Risk Scores during Three Waves of Pandemic in a German Cohort—A Retrospective Study
title_short External Validation of COVID-19 Risk Scores during Three Waves of Pandemic in a German Cohort—A Retrospective Study
title_sort external validation of covid-19 risk scores during three waves of pandemic in a german cohort—a retrospective study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9693591/
https://www.ncbi.nlm.nih.gov/pubmed/36579493
http://dx.doi.org/10.3390/jpm12111775
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