Fast track triage for COVID-19 based on a population study: The soda score

Javier Lopez-Pais; Diego López Otero; Teba Gonzalez Ferreiro; Carla Eugenia Cacho Antonio; Pablo José Antúnez Muiños; Marta Perez-Poza; Óscar Otero García; Victor Jimenez Ramos; Manuela Sestayo Fernández; María Bastos Fernandez; Xoan Carlos Sanmartin Pena; Alfonso Varela Roman; Manuel Portela Romero; Ana López Lago; Julián Álvarez Escudero; Alberto San Román; Jose Ramón Gonzalez-Juanatey; CARDIOVID investigators

doi:10.1016/j.pmedr.2020.101298

Fast track triage for COVID-19 based on a population study: The soda score

Prev Med Rep. 2020 Dec 29:21:101298. doi: 10.1016/j.pmedr.2020.101298. eCollection 2021 Mar.

Authors

Javier Lopez-Pais^{1

2}, Diego López Otero^{1

2}, Teba Gonzalez Ferreiro¹, Carla Eugenia Cacho Antonio¹, Pablo José Antúnez Muiños¹, Marta Perez-Poza¹, Óscar Otero García¹, Victor Jimenez Ramos¹, Manuela Sestayo Fernández¹, María Bastos Fernandez^{1

2

3}, Xoan Carlos Sanmartin Pena^{1

2

3}, Alfonso Varela Roman^{1

2

3}, Manuel Portela Romero⁴, Ana López Lago⁵, Julián Álvarez Escudero⁶, Alberto San Román⁷, Jose Ramón Gonzalez-Juanatey^{1

2}; CARDIOVID investigators

Affiliations

¹ Cardiology Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
² CIBERCV, Spain.
³ Instituto de Investigación Sanitaria IDICHUS, Spain.
⁴ Primary Healthcare, Centro de Salud Concepción Arenal, Santiago de Compostela, Spain.
⁵ Intensive Care Unit, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
⁶ Anaesthesia Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
⁷ Cardiology Department, University Clinical Hospital of Valladolid, Valladolid, Spain.

Abstract

Background: Healthcare systems are under prominent stress due to the COVID-19 pandemic. A fast and simple triage is mandatory to screen patients who will benefit from early hospitalization, from those that can be managed as outpatients. There is a lack of all-comers scores, and no score has been proposed for western-world population.

Aims: To develop a fast-track risk score valid for every COVID-19 patient at diagnosis.

Methods: Single-center, retrospective study based on all the inhabitants of a healthcare area. Logistic regression was used to identify simple and wide-available risk factors for adverse events (death, intensive care admission, invasive mechanical ventilation, bleeding > BARC3, acute renal injury, respiratory insufficiency, myocardial infarction, acute heart failure, pulmonary emboli, or stroke).

Results: Of the total healthcare area population, 447.979 inhabitants, 965 patients (0.22%), were diagnosed with COVID-19. A total of 124 patients (12.85%) experienced adverse events. The novel SODA score (based on sex, peripheral O₂ saturation, presence of diabetes, and age) demonstrated good accuracy for adverse events prediction (area under ROC curve 0.858, CI: 0.82-0.98). A cut-off value of ≤2 points identifies patients with low risk (positive predictive value [PPV] for absence of events: 98.9%) and a cut-off of ≥5 points, high-risk patients (PPV 58.8% for adverse events).

Conclusions: This quick and easy score allows fast-track triage at the moment of diagnosis for COVID-19 using four simple variables: age, sex, SpO₂, and diabetes. SODA score could improve preventive measures taken at diagnosis in high-risk patients and also relieve resources by identifying very low-risk patients.

Keywords: COVID-19; COVID-19, Coronavirus Disease 2019; Fast-track; ICU, Intensive Care Unit; IMV, Invasive Mechanical Ventilation; Prognosis; ROC, Receiver Operating Characteristic; SARS, Severe Acute Respiratory Syndrome; SARS-COV-2, SARS Coronavirus 2; Score; SpO2, Peripheral O2 Saturation; Triage.