COMPARISON OF SOFA, QSOFA, AND MSOFA SCORES BASED ON SEROLOGY IN PATIENTS WITH COVID-19: A RETROSPECTIVE COHORT STUDY

Patel, Aditya; Ali, Ruhma; Hoe Chan, Kok; slim, jihad; Miller, Richard; Komer, Claudia; Bellary, Sharath

TOPIC: Chest Infections TYPE: Original Investigations PURPOSE: The assessment of severity and prognosis of patients with SARS-CoV-2 infection on admission is paramount to better triage the patient and predict the in-hospital mortality. Herein, we aim to evaluate the prognostic value of SOFA, qSOFA and mSOFA scores on the need of mechanical ventilation and outcome. We also hope to use the scoring system to better classify the different stages of disease in relation with the serology (IgM/IgG). METHODS: This is a retrospective cohort study of patients with COVID-19 admitted to our hospital between 10/1/2020 to 2/28/2021. Inclusion criteria was a well defined clinical outcome i.e., survived or expired and available serology. Demographics, and lab data were reviewed. Simple t-test was used for continuous variables and chi-square test was used for categorical variables. Univariate analysis was used to identify the potential predictive value of SOFA, qSOFA and mSOFA for the need of mechanical ventilation and outcome. GraphPad PRISM was used for all analysis. RESULTS: A total of 202 patients were included during the study period. Majority were latinx and black. Diabetes and hypertension were the most common comorbidities. High SOFA, qSOFA and mSOFA score were significantly associated with risk of mechanical ventilation (Log-likelihood ratio of 31.15, 11.24 and 42.45 respectively with p-value of <0.0001, 0.008 and <0.0001 respectively) and in-patient mortality (Log-likelihood ratio of 35.92, 7.12 and 47.42 respectively with p-value of <0.0001, 0.0076 and <0.0001 respectively). When comparing these scoring systems, mSOFA was better in mechanical ventilation prediction (AUC 0.8483) and mortality prediction (AUC 0.8882) as compared to SOFA and qSOFA. We further classified the patients into different stages of disease based on serology to determine a difference in the scoring system. 47 patients were classified into pre-cytokine storm stage with both IgM and IgG negative;116 patients into cytokine storm stage with IgM positive and 39 patients in post-cytokine storm stages with IgM negative and IgG positive. When comparing scores with different stages of the disease, patients in the pre-cytokine storm stage exhibited significantly higher scores. The significantly higher score in the pre-cytokine storm stage may help to predict the need of mechanical ventilation and mortality in this subgroup. Studies with larger sample size are required to evaluate the correlation between higher scores in the pre-cytokine storm stage with the need of mechanical ventilation and in-patient mortality. CONCLUSIONS: This study highlighted the role of SOFA, qSOFA and mSOFA scores to predict the need of mechanical ventilation and in-patient mortality. Larger prospective studies will be required to correlate these findings. CLINICAL IMPLICATIONS: The study shows the use of mSOFA and SOFA scores at admission on predicting the use of mechanical ventilation and outcome in different stage of the disease. DISCLOSURES: No relevant relationships by Ruhma Ali, source=Web Response No relevant relationships by Sharath Bellary, source=Web Response No relevant relationships by Kok Hoe Chan, source=Web Response No relevant relationships by Claudia Komer, source=Web Response No relevant relationships by Richard Miller, source=Web Response No relevant relationships by Aditya Patel, source=Web Response Speaker/Speaker's Bureau relationship with Gilead Please note: $5001 - $20000 by jihad slim, source=Web Response, value=Honoraria Speaker/Speaker's Bureau relationship with ViiV Please note: $5001 - $20000 by jihad slim, source=Web Response, value=Honoraria Speaker/Speaker's Bureau relationship with Abbvie Please note: $5001 - $20000 by jihad slim, source=Web Response, value=Honoraria Speaker/Speaker's Bureau relationship with merck Please note: $5001 - $20000 by jihad slim, source=Web Response, value=Honoraria Speaker/Speaker's Bureau relationship with Jansen Please note: $5001 - $20000 by jihad slim, source=Web Response, value=Honoraria