Factors Associated with ICU Admission in Patients with COVID-19: The GOL2DS Score
Marcello Candelli,
Giulia Pignataro,
Miriana Ferrigno,
Sara Cicchinelli,
Enrico Torelli,
Antonio Gullì,
Marta Sacco Fernandez,
Andrea Piccioni,
Veronica Ojetti,
Marcello Covino,
Antonio Gasbarrini,
Massimo Antonelli,
Francesco Franceschi
Affiliations
Marcello Candelli
Emergency Medicine Department—Fondazione, Universitaria Policlinico Agostino Gemelli–IRCCS–Catholic, University of Sacred Heart of Rome, 100168 Rome, Italy
Giulia Pignataro
Emergency Medicine Department—Fondazione, Universitaria Policlinico Agostino Gemelli–IRCCS–Catholic, University of Sacred Heart of Rome, 100168 Rome, Italy
Miriana Ferrigno
Emergency Medicine Department—Fondazione, Universitaria Policlinico Agostino Gemelli–IRCCS–Catholic, University of Sacred Heart of Rome, 100168 Rome, Italy
Sara Cicchinelli
Emergency Medicine Department—Fondazione, Universitaria Policlinico Agostino Gemelli–IRCCS–Catholic, University of Sacred Heart of Rome, 100168 Rome, Italy
Enrico Torelli
Emergency Medicine Department—Fondazione, Universitaria Policlinico Agostino Gemelli–IRCCS–Catholic, University of Sacred Heart of Rome, 100168 Rome, Italy
Antonio Gullì
Emergency, Anesthesiological and Reanimation Sciences—Fondazione, Universitaria Policlinico Agostino Gemelli–IRCCS–Catholic, Faculty of Medicine, University of Sacred Heart of Rome, 100168 Rome, Italy
Marta Sacco Fernandez
Emergency Medicine Department—Fondazione, Universitaria Policlinico Agostino Gemelli–IRCCS–Catholic, University of Sacred Heart of Rome, 100168 Rome, Italy
Andrea Piccioni
Emergency Medicine Department—Fondazione, Universitaria Policlinico Agostino Gemelli–IRCCS–Catholic, University of Sacred Heart of Rome, 100168 Rome, Italy
Veronica Ojetti
Emergency Medicine Department—Fondazione, Universitaria Policlinico Agostino Gemelli–IRCCS–Catholic, University of Sacred Heart of Rome, 100168 Rome, Italy
Marcello Covino
Emergency Medicine Department—Fondazione, Universitaria Policlinico Agostino Gemelli–IRCCS–Catholic, University of Sacred Heart of Rome, 100168 Rome, Italy
Antonio Gasbarrini
Department of Medical and Surgical Sciences—Fondazione, Universitaria Policlinico Agostino Gemelli–IRCCS–Catholic, University of Sacred Heart of Rome, 100168 Rome, Italy
Massimo Antonelli
Emergency, Anesthesiological and Reanimation Sciences—Fondazione, Universitaria Policlinico Agostino Gemelli–IRCCS–Catholic, Faculty of Medicine, University of Sacred Heart of Rome, 100168 Rome, Italy
Francesco Franceschi
Emergency Medicine Department—Fondazione, Universitaria Policlinico Agostino Gemelli–IRCCS–Catholic, University of Sacred Heart of Rome, 100168 Rome, Italy
Background and Objectives: The COVID-19 pandemic has been shaking lives around the world for nearly two years. The discovery of highly effective vaccines has not been able to stop the transmission of the virus. SARS-CoV-2 shows completely different clinical manifestations. A large percentage (about 40%) of admitted patients require treatment in an intensive care unit (ICU). This study investigates the factors associated with admission of COVID-19 patients to the ICU and whether it is possible to obtain a score that can help the emergency physician to select the hospital ward. Materials and Methods: We retrospectively recorded 313 consecutive patients who were presented to the emergency department (ED) of our hospital and had a diagnosis of COVID-19 confirmed by polymerase chain reaction (PCR) on an oropharyngeal swab. We used multiple logistic regression to evaluate demographic, clinical, and laboratory data statistically associated with ICU admission. These variables were used to create a prognostic score for ICU admission. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and receiver-operating characteristic curve (ROC) of the score for predicting ICU admission during hospitalization were calculated. Results: Of the variables evaluated, only blood type A (p = 0.003), PaO2/FiO2 (p = 0.002), LDH (p = 0.004), lactate (p = 0.03), dyspnea (p = 0.03) and SpO2 (p = 0.0228) were significantly associated with ICU admission after adjusting for sex, age and comorbidity using multiple logistic regression analysis. We used these variables to create a prognostic score called GOL2DS (group A, PaO2/FiO2, LDH, lactate and dyspnea, and SpO2), which had high accuracy in predicting ICU admission (AUROC 0.830 [95% CI, 0.791–0.892). Conclusions: In our single-center experience, the GOL2DS score could be useful in identifying patients at high risk for ICU admission.
