Critical Care Explorations (Oct 2020)

Clinical Risk Prediction Scores in Coronavirus Disease 2019: Beware of Low Validity and Clinical Utility

  • Haamed Al Hassan, MB BCh,
  • Eve Cocks, DN,
  • Lara Jesani, MB BCh,
  • Sally Lewis, MRCGP,
  • Tamas Szakmany, MD, PhD,
  • on behalf of the Gwent COVID-19 Group,
  • A. Allen-Ridge,
  • E. Baker,
  • C. Bailey,
  • T. Baumer,
  • S. Beckett,
  • S. Champanerkar,
  • Y. Cheema,
  • S. Cherian,
  • E. Cocks,
  • S. Cutler,
  • E. Dawe,
  • A. Dhadda,
  • S. Dumont,
  • N. Duric,
  • S. Elgarf,
  • T. Evans,
  • E. Godfrey,
  • L. Harding,
  • D. Hepburn,
  • A. E. Heron,
  • L. Jesani,
  • P. Jones,
  • C. Killick,
  • C. King,
  • A. Kiss,
  • J. Lavers,
  • J. Lloyd-Evans,
  • N. Mason,
  • L. McClelland,
  • B. Muthuswamy,
  • J. Parry-Jones,
  • E. Phillips,
  • S. Pooley,
  • B. Radford,
  • O. Richards,
  • A. Rimmer,
  • G. Roberts,
  • A. Roynon-Reed,
  • A. Sieunarine,
  • K. Sullivan,
  • T. Szakmany,
  • C. Thomas,
  • E. Thomas,
  • J. Tozer,
  • T. West,
  • M. Winstanley

DOI
https://doi.org/10.1097/CCE.0000000000000253
Journal volume & issue
Vol. 2, no. 10
p. e0253

Abstract

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Several risk stratification tools were developed to predict disease progression in coronavirus disease 2019, with no external validation to date. We attempted to validate three previously published risk-stratification tools in a multicenter study. Primary outcome was a composite outcome of development of severe coronavirus disease 2019 disease leading to ICU admission or death censored at hospital discharge or 30 days. We collected data from 169 patients. Patients were 73 years old (59–82 yr old), 66 of 169 (39.1%) were female, 57 (33.7%) had one comorbidity, and 80 (47.3%) had two or more comorbidities. Area under the receiver operating characteristic curve (95% CI) for the COVID-GRAM score was 0.636 (0.550–0.722), for the CALL score 0.500 (0.411–0.589), and for the nomogram 0.628 (0.543–0.714).