Predicting mechanical ventilation, intensive care unit admission, and mortality in COVID-19 patients: Comparison of seven different scoring systems

Abstract

Objective: In this study, we investigated whether scoring systems determine coronavirus disease-2019 (COVID-19) severity. Materials and Methods: COVID-19 patients hospitalized between 01.09.2020 and 31.04.2021 were retrospectively assessed. The national early warning score (NEWS), modified early warning score, rapid emergency medicine score, quick sequential organ failure assessment score (q-SOFA), CURB65, MuLBSTA, and ISARIC-4C scores on admission day were calculated. Scoring systems' ability to predict mechanical ventilation (MV) need, intensive care unit (ICU) admission, and 30-day mortality were assessed. Results: A total of 292 patients were included; 137 (46.9%) were female, and the mean age was 62.5 +/- 15.4 years. 69 (23.6%) patients required ICU admission, 45 (15.4%) needed MV, and 49 (16.8%) died within 30 days. No relationship was found between q-SOFA and MV need (p=0.167), but a statistically significant relationship was found between other scoring systems and MV need, ICU admission, and 30-day mortality (p<0.05). ISARIC-4C (optimal cut-off >5.5) and NEWS (optimal cut-off >3.5) had the highest area under the curve in receiver operating characteristic curve analyses, whereas q-SOFA had the lowest. Conclusion: The severity of COVID-19 could be estimated by using these scoring systems, especially ISARIC-4C and NEWS, at the first admission. Thus, mortality and morbidity would be reduced by making the necessary interventions earlier. Keywords: COVID-19, ISARIC-4C, mortality, NEWS, scoring systems