[C-Reactive protein and SOFA scale: a simple score as early predictor of critical care requirement in patients with COVID-19 pneumonia in Spain.]

Vaquero-Roncero, Luis Mario; Sánchez-Barrado, Elisa; Escobar-Macias, Daniel; Arribas-Pérez, Pilar; González, Rafael; Ramón Gonzalez-Porras, José; Sánchez-Hernandez, Miguel Vicente

OBJECTIVE To identify potential markers at admission predicting the need for critical care in patients with COVID-19 pneumonia. MATERIAL AND METHODS An approved, observational, retrospective study was conducted between March 15 to April 15, 2020. 150 adult patients aged less than 75 with Charlson comorbidity index ≤ 6 diagnosed with COVID-19 pneumonia were included. Seventy-five patients were randomly selected from those admitted to the critical care units (Critical care group (CG)) and seventy-five hospitalized patients who did not require critical care (Non-Critical care group (nCG)) represent the control group. One additional cohort of hospitalized patiens with COVID-19 were used to validate the score. MEASUREMENTS AND MAIN RESULTS Multivariable regression showed increasing odds of in-hospital critical care associated with increased C-reactive protein (CRP) (odds ratio 1.052 (1.009-1.101); p=0·0043) and higher Sequential Organ Failure Assessment (SOFA) score (1.968 (1.389-2.590); p<0·0001), both at the time of hospital admission. The AUC-ROC for the combined model was 0.83 (0.76-0.90) (vs AUC-ROC SOFA p<0.05). The AUC-ROC for the validation cohort was 0.89 (0.82-0.95) (p>0.05 vs AUC-ROC development). CONCLUSION Patients COVID-19 presenting at admission SOFA score ≥2 combined with CRP ≥ 9,1 mg/mL could help clinicians to identify them at high risk to require critical care.