Outcome prediction in hospitalized COVID-19 patients: Comparison of the performance of five severity scores

Hsin-Pei Chung; Yen-Hsiang Tang; Chun-Yen Chen; Chao-Hsien Chen; Wen-Kuei Chang; Kuan-Chih Kuo; Yen-Ting Chen; Jou-Chun Wu; Chang-Yi Lin; Chieh-Jen Wang

doi:10.3389/fmed.2023.1121465

Outcome prediction in hospitalized COVID-19 patients: Comparison of the performance of five severity scores

Front Med (Lausanne). 2023 Feb 8:10:1121465. doi: 10.3389/fmed.2023.1121465. eCollection 2023.

Authors

Hsin-Pei Chung^{1

2}, Yen-Hsiang Tang^{2

3}, Chun-Yen Chen⁴, Chao-Hsien Chen^{1

2}, Wen-Kuei Chang^{1

2}, Kuan-Chih Kuo^{1

2}, Yen-Ting Chen^{1

2}, Jou-Chun Wu^{1

2}, Chang-Yi Lin^{1

2}, Chieh-Jen Wang^{1

2}

Affiliations

¹ Division of Pulmonary, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan.
² Department of Critical Care Medicine, MacKay Memorial Hospital, Taipei, Taiwan.
³ Department of Medicine, MacKay Medical College, New Taipei City, Taiwan.
⁴ Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan.

Abstract

Background: The aim of our study was to externally validate the predictive capability of five developed coronavirus disease 2019 (COVID-19)-specific prognostic tools, including the COVID-19 Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), Shang COVID severity score, COVID-intubation risk score-neutrophil/lymphocyte ratio (IRS-NLR), inflammation-based score, and ventilation in COVID estimator (VICE) score.

Methods: The medical records of all patients hospitalized for a laboratory-confirmed COVID-19 diagnosis between May 2021 and June 2021 were retrospectively analyzed. Data were extracted within the first 24 h of admission, and five different scores were calculated. The primary and secondary outcomes were 30-day mortality and mechanical ventilation, respectively.

Results: A total of 285 patients were enrolled in our cohort. Sixty-five patients (22.8%) were intubated with ventilator support, and the 30-day mortality rate was 8.8%. The Shang COVID severity score had the highest numerical area under the receiver operator characteristic (AUC-ROC) (AUC 0.836) curve to predict 30-day mortality, followed by the SEIMC score (AUC 0.807) and VICE score (AUC 0.804). For intubation, both the VICE and COVID-IRS-NLR scores had the highest AUC (AUC 0.82) compared to the inflammation-based score (AUC 0.69). The 30-day mortality increased steadily according to higher Shang COVID severity scores and SEIMC scores. The intubation rate exceeded 50% in the patients stratified by higher VICE scores and COVID-IRS-NLR score quintiles.

Conclusion: The discriminative performances of the SEIMC score and Shang COVID severity score are good for predicting the 30-day mortality of hospitalized COVID-19 patients. The COVID-IRS-NLR and VICE showed good performance for predicting invasive mechanical ventilation (IMV).

Keywords: COVID-19; IRS-NLR score; SEIMC score; VICE score; mortality prediction.