Analysis of Oxygen Blood Saturation/Respiratory Rate Index, NEWS2, CURB65, and quick Sequential Organ Failure Assessment Scores to Assess Prognosis in Patients with Mild Coronavirus Disease 2019.

BACKGROUND: Hospital bed saturation has been one of the problems to solve during the SARS-CoV-2 pandemic. However, not every patient who is admitted requires close monitoring or specific therapeutics. Mild cases could be managed in the outpatient setting. OBJECTIVE: Our study aimed to analyze the accuracy of the oxygen saturation/respiratory rate (sat/RR) index, NEWS2, CURB65, and quick Sequential Organ Failure Assessment (qSOFA) scores to predict supplemental oxygen requirement and prolonged hospital stay in patients with mild coronavirus disease 2019 (COVID-19). METHODS: A prospective cohort study in an academic medical center. We compared the values of these scores according to the occurrence or not of each outcome. When differences between groups were statistically significant, the discriminatory capacity of the score for that outcome was analyzed. RESULTS: We included 271 patients. Of them, 11.07% required supplemental oxygen, showing significantly higher values of NEWS2 score and qSOFA score, and lower values of Sat/RR index. About 38% presented prolonged hospital stay, with significantly higher values of NEWS2 score and lower values of sat/RR index. The ROC curve area under the curve (AUC) of sat/RR index to discriminate the requirement of supplemental oxygen was 0.72 (CI 95% 0.61-0.84). The ROC curve of NEWS2 and qSOFA for the same outcome was 0.75 (95% [95% CI 0.65-0.85]) and 0.66 (95% CI 0.57-0.76), respectively. The ability of the Sat/RR index to discriminate the requirement of prolonged hospitalization showed an AUC of 0.67 (95% [95% CI 0.60- 0.73]). The NEWS2 score showed an AUC of 0.63 (CI 95% 0.56-0.70) for the same outcome. CONCLUSIONS: sat/RR index and NEWS2 score have a good capacity to discriminate patients at risk of clinical worsening, being the Sat/RR index simpler and easier to calculate.

Development of simple and sensitive score to assess the risk of pneumonia in Covid-19 patients

ABSTRACT Background: Severe pneumonia is the most common cause of intensive care unit (ICU) admission and death due to novel coronavirus (SARS-CoV-2) respiratory disease (COVID-19). Due to its rapid outbreak, units for the evaluation of febrile patients in the pre-hospital setting were created. Objective: The objective of the study was to develop a sensitive and simple tool to assess the risk of pneumonia in COVID-19 patients and thus select which patients would require a chest imaging study. Materials and Methods: We conducted a cross-sectional study in a cohort of individuals with suspected COVID-19 evaluated in a public academic healthcare center in Buenos Aires city. All adult patients with positive RT-PCR assay for SARS-COV2 between April 24 and May 19 of 2020 were included in the study. Pneumonia was defined as the presence of compatible signs and symptoms with imaging confirmation. Univariate and multivariate logistic regression was performed. A risk indicator score was developed. Results: One hundred and forty-eight patients were included, 71 (48%) received the diagnosis of pneumonia. The final clinical model included four variables: age ≥ 40 years, cough, absence of sore throat, and respiratory rate ≥ 22. To create the score, we assigned values to the variables according to their ORs: 2 points for respiratory rate ≥ 22 and 1 point to the other variables. The AUC of the ROC curve was 0.80 (CI 95% 0.73-0.86). A cutoff value of 2 showed a sensitivity of 95.7% and a specificity of 43.24%. Conclusion: This sensible score may improve the risk stratification of COVID-19 patients in the pre-hospital setting. (REV INVEST CLIN. 2021;73(1):52-8)

Development of Simple and Sensitive Score to Assess the Risk of Pneumonia in COVID-19 Patients.

BACKGROUND: Severe pneumonia is the most common cause of intensive care unit (ICU) admission and death due to novel coronavirus (SARS-CoV-2) respiratory disease (COVID-19). Due to its rapid outbreak, units for the evaluation of febrile patients in the pre-hospital setting were created. OBJECTIVE: The objective of the study was to develop a sensitive and simple tool to assess the risk of pneumonia in COVID-19 patients and thus select which patients would require a chest imaging study. MATERIALS AND METHODS: We conducted a cross-sectional study in a cohort of individuals with suspected COVID-19 evaluated in a public academic healthcare center in Buenos Aires city. All adult patients with positive RT-PCR assay for SARS-COV2 between April 24 and May 19 of 2020 were included in the study. Pneumonia was defined as the presence of compatible signs and symptoms with imaging confirmation. Univariate and multivariate logistic regression was performed. A risk indicator score was developed. RESULTS: One hundred and forty-eight patients were included, 71 (48%) received the diagnosis of pneumonia. The final clinical model included four variables: age >- 40 years, cough, absence of sore throat, and respiratory rate >- 22. To create the score, we assigned values to the variables according to their ORs: 2 points for respiratory rate >- 22 and 1 point to the other variables. The AUC of the ROC curve was 0.80 (CI 95% 0.73-0.86). A cutoff value of 2 showed a sensitivity of 95.7% and a specificity of 43.24%. CONCLUSION: This sensible score may improve the risk stratification of COVID-19 patients in the pre-hospital setting.