A Systematic Review of Predictor Composition, Outcomes, Risk of Bias, and Validation of COVID-19 Prognostic Scores.
Clin Infect Dis
; 78(4): 889-899, 2024 Apr 10.
Article
em En
| MEDLINE
| ID: mdl-37879096
ABSTRACT
BACKGROUND:
Numerous prognostic scores have been published to support risk stratification for patients with coronavirus disease 2019 (COVID-19).METHODS:
We performed a systematic review to identify the scores for confirmed or clinically assumed COVID-19 cases. An in-depth assessment and risk of bias (ROB) analysis (Prediction model Risk Of Bias ASsessment Tool [PROBAST]) was conducted for scores fulfilling predefined criteria ([I] area under the curve [AUC)] ≥ 0.75; [II] a separate validation cohort present; [III] training data from a multicenter setting [≥2 centers]; [IV] point-scale scoring system).RESULTS:
Out of 1522 studies extracted from MEDLINE/Web of Science (20/02/2023), we identified 242 scores for COVID-19 outcome prognosis (mortality 109, severity 116, hospitalization 14, long-term sequelae 3). Most scores were developed using retrospective (75.2%) or single-center (57.1%) cohorts. Predictor analysis revealed the primary use of laboratory data and sociodemographic information in mortality and severity scores. Forty-nine scores were included in the in-depth analysis. The results indicated heterogeneous quality and predictor selection, with only five scores featuring low ROB. Among those, based on the number and heterogeneity of validation studies, only the 4C Mortality Score can be recommended for clinical application so far.CONCLUSIONS:
The application and translation of most existing COVID scores appear unreliable. Guided development and predictor selection would have improved the generalizability of the scores and may enhance pandemic preparedness in the future.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
COVID-19
Tipo de estudo:
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
Clin Infect Dis
Assunto da revista:
DOENCAS TRANSMISSIVEIS
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Alemanha