Mortality in patients treated for COVID-19 in the emergency department of a tertiary care hospital during the first phase of the pandemic: Derivation of a risk model for emergency departments.

García-Martínez, Ana; López-Barbeito, Beatriz; Coll-Vinent, Blanca; Placer, Arrate; Font, Carme; Rosa Vargas, Carmen; Sánchez, Carolina; Piñango, Daniela; Gómez-Angelats, Elisenda; Curtelin, David; Salgado, Emilio; Aya, Francisco; Martínez-Nadal, Gemma; Alonso, José Ramón; García-Gozalbes, Julia; Fresco, Leticia; Galicia, Miguel; Perea, Milagrosa; Carbó, Miriam; Iniesta, Nerea; Escoda, Ona; Perelló, Rafael; Cuerpo, Sandra; Flores, Vanesa; Alemany, Xavier; Miró, Òscar; Ortega Romero, Mª Del Mar

OBJECTIVES To develop a risk model to predict 30-day mortality after emergency department treatment for COVID-19. MATERIAL AND METHODS Observational retrospective cohort study including 2511 patients with COVID-19 who came to our emergency department between March 1 and April 30, 2020. We analyzed variables with Kaplan Meier survival and Cox regression analyses. RESULTS All-cause mortality was 8% at 30 days. Independent variables associated with higher risk of mortality were age over 50 years, a Barthel index score less than 90, altered mental status, the ratio of arterial oxygen saturation to the fraction of inspired oxygen (SaO2/FIO2), abnormal lung sounds, platelet concentration less than 100 000/mm3, a C-reactive protein concentration of 5 mg/dL or higher, and a glomerular filtration rate less than 45 mL/min. Each independent predictor was assigned 1 point in the score except age, which was assigned 2 points. Risk was distributed in 3 levels: low risk (score of 4 points or less), intermediate risk (5 to 6 points), and high risk (7 points or above). Thirty-day risk of mortality was 1.7% for patients who scored in the low-risk category, 28.2% for patients with an intermediate risk score, and 67.3% for those with a high risk score. CONCLUSION This mortality risk stratification tool for patients with COVID-19 could be useful for managing the course of disease and assigning health care resources in the emergency department.