The COVID-19 lab score: an accurate dynamic tool to predict in-hospital outcomes in COVID-19 patients

• Published in: Scientific reports 2021-04, Vol.11 (1), p.9361-9, Article 9361
• Main Authors: Antunez Muiños, Pablo Jose, López Otero, Diego, Amat-Santos, Ignacio J., López País, Javier, Aparisi, Alvaro, Cacho Antonio, Carla E., Catalá, Pablo, González Ferrero, Teba, Cabezón, Gonzalo, Otero García, Oscar, Gil, José Francisco, Pérez Poza, Marta, Candela, Jordi, Rojas, Gino, Jiménez Ramos, Víctor, Veras, Carlos, San Román, J. Alberto, González-Juanatey, José R.
• Format: Article
• Language: English
• Subjects: 692/308; 692/699/255; Aged; Biomarkers - analysis; C-reactive protein; Clinical deterioration; Coronaviruses; COVID-19; COVID-19 - diagnosis; COVID-19 - mortality; COVID-19 - pathology; COVID-19 - therapy; Creatinine; Erythrocytes; Female; Health risks; Hemoglobin; Hospitalization; Humanities and Social Sciences; Humans; Interleukin 6; L-Lactate dehydrogenase; Laboratories; Lactic acid; Leukocytes (neutrophilic); Lymphocytes; Male; Mechanical ventilation; Mortality; Mortality risk; multidisciplinary; Multivariate Analysis; Patients; Procalcitonin; Retrospective Studies; Risk Assessment; Risk groups; SARS-CoV-2 - physiology; Science; Science (multidisciplinary); Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Spain - epidemiology; Treatment Outcome
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-88679-6

Deterioration is sometimes unexpected in SARS-CoV2 infection. The aim of our study is to establish laboratory predictors of mortality in COVID-19 disease which can help to identify high risk patients. All patients admitted to hospital due to Covid-19 disease were included. Laboratory biomarkers that contributed with significant predictive value for predicting mortality to the clinical model were included. Cut-off points were established, and finally a risk score was built. 893 patients were included. Median age was 68.2 ± 15.2 years. 87(9.7%) were admitted to Intensive Care Unit (ICU) and 72(8.1%) needed mechanical ventilation support. 171(19.1%) patients died. A Covid-19 Lab score ranging from 0 to 30 points was calculated on the basis of a multivariate logistic regression model in order to predict mortality with a weighted score that included haemoglobin, erythrocytes, leukocytes, neutrophils, lymphocytes, creatinine, C-reactive protein, interleukin-6, procalcitonin, lactate dehydrogenase (LDH), and D-dimer. Three groups were established. Low mortality risk group under 12 points, 12 to 18 were included as moderate risk, and high risk group were those with 19 or more points. Low risk group as reference, moderate and high patients showed mortality OR 4.75(CI95% 2.60–8.68) and 23.86(CI 95% 13.61–41.84), respectively. C-statistic was 0–85(0.82–0.88) and Hosmer–Lemeshow p-value 0.63. Covid-19 Lab score can very easily predict mortality in patients at any moment during admission secondary to SARS-CoV2 infection. It is a simple and dynamic score, and it can be very easily replicated. It could help physicians to identify high risk patients to foresee clinical deterioration.