Utility of early warning scores to predict mortality in COVID-19 patients: A retrospective observational study

Kaeley, N.; Mahala, P.; Kabi, A.; Choudhary, S.; Hazra, A. G.; Vempalli, S.

Background: Coronavirus disease 2019 (COVID19) has evolved as a global pandemic. The patients with COVID-19 infection can present as mild, moderate, and severe disease forms. The reported mortality of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection is around 6.6%, which is lower than that of SARS-CoV and (middle east respiratory syndrome CoV). However, the fatality rate of COVID-19 infection is higher in the geriatric age group and in patients with multiple co-morbidities. The study aimed to evaluate the utility of early warning scores (EWS) to predict mortality in patients with moderate to severe COVID-19 infection. Methods: This retrospective study was carried out in a tertiary care institute of Uttarakhand. Demographic and clinical data of the admitted patients with moderate-to-severe COVID-19 infection were collected from the hospital record section and utilized to calculate the EWS-National early warning score (NEWS), modified early warning score (MEWS), Rapid Acute Physiology Score (RAPS), rapid emergency medicine score (REMS), and worthing physiological scoring system (WPS). Results: The area under the curve for NEWS, MEWS, RAPS, REMS, and WPS was 0.813 (95% confidence interval [CI];0.769-0.858), 0.770 (95% CI;0.717-0.822), 0.755 (95% CI;0.705-0.805), 0.892 (95% CI;0.859-0.924), and 0.892 (95% CI;0.86-0.924), respectively. Conclusion: The EWS at triage can be used for early assessment of severity as well as predict mortality in patients with COVID-19 patients. © 2021 International Journal of Critical Illness and Injury Science ;Published by Wolters Kluwer-Medknow.