Validation of two severity scores as predictors for outcome in Coronavirus Disease 2019 (COVID-19)

An established objective and standardized reporting of clinical severity and disease progression in COVID-19 is still not established. We validated and compared the usefulness of two classification systems reported earlier-a severity grading proposed by Siddiqi and a system from the National Austral...

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Bibliographic Details
Published in:PloS one 2021-02, Vol.16 (2), p.e0247488-e0247488
Main Authors: Salbach, Christian, Mueller-Hennessen, Matthias, Biener, Moritz, Stoyanov, Kiril M, Vafaie, Mehrshad, Preusch, Michael R, Kihm, Lars P, Merle, Uta, Schnitzler, Paul, Katus, Hugo A, Giannitsis, Evangelos
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biology and Life Sciences
Blood pressure
Cardiology
Classification
Classification systems
Comparative analysis
Complications
Coronaviruses
COVID-19
COVID-19 - mortality
Data analysis
Disease
Embolisms
Female
Follow-Up Studies
Hospitals
Humans
Infections
Intensive care
Internal medicine
Laboratories
Male
Medical records
Medicine
Medicine and Health Sciences
Middle Aged
Mortality
Normal distribution
Oxygen
Oxygen content
Oxygen saturation
Physical Sciences
Physicians
Pneumonia
Practice guidelines (Medicine)
Predictive Value of Tests
Respiration
Respiratory rate
Retrospective Studies
Risk Factors
SARS-CoV-2
Saturation
Severe acute respiratory syndrome coronavirus 2
Severity of Illness Index
Supervision
Variables
Viral diseases
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Summary:An established objective and standardized reporting of clinical severity and disease progression in COVID-19 is still not established. We validated and compared the usefulness of two classification systems reported earlier-a severity grading proposed by Siddiqi and a system from the National Australian COVID-19 guideline. Both had not been validated externally and were now tested for their ability to predict complications. In this retrospective, single-centre observational study, patients hospitalized with confirmed COVID-19 across all severity stages were enrolled. The clinical severity was graded at admission and during hospitalization. Multivariate Cox regression was used to identify independent risk factors for mortality, a composite primary (mortality, incident acute respiratory distress syndrome, incident mechanical ventilation), a secondary endpoint (mortality, incident acute myocardial injury, incident venous thrombosis, pulmonary embolism or stroke) and progression of severity grades. Of 109 patients 17 died, 31 and 48 developed the primary and secondary endpoint, respectively. Worsening of the severity grade by at least one stage occurred in 27 and 28 patients, respectively. Siddiqi and Australian classification were identified as independent predictors for the primary endpoint (adjusted hazard ratio (aHR) 2.30, p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0247488