Evaluation of prognostic scales for patients hospitalized with sars-cov2 infection in a private clinic in Córdoba

Abstract

INTRODUCTION: Prognostic scores are useful tools for the clinical management of COVID-19 infection, as they allow for timely recognition of severe disease for appropriate intensive care and accurate risk stratification in hospitalized patients. The objective of this study was to evaluate the usefulness of the 4C, NEWS2, and CALL prognostic scores in identifying patients with severe COVID-19 disease, high risk of admission to a critical care unit (ICU), and mortality in the context of regular ward admission.

MATERIALS AND METHODS: A retrospective, observational design was used. Adult patients diagnosed
with COVID-19 and hospitalized in a general ward in 2020 were evaluated. The 4C, NEWS2, and CALL
scores were calculated, along with their correlation with the need for ICU transfer and in-hospital mortality.
ROC curve analysis was performed, calculating the area under the curve for the different scales, as well as
sensitivity, specificity, and predictive values.
RESULTS: A total of 113 patients were included in the study. The areas under the ROC curves for the requirement for ICU admission were: 4C scale = 0.52 (95% CI = 0.44 - 0.60), CALL scale = 0.80 (95% CI = 0.74 - 0.86), NEWS 2 scale = 0.71 (95% CI = 0.64 - 0.78). The areas under the ROC curves for mortality were: 4C scale = 0.91 (95% CI = 0.87 - 0.94), CALL scale = 0.88 (95% CI = 0.83 - 0.92), NEWS 2 scale = 0.81 (95% CI = 0.75 - 0.87).
CONCLUSION: The CALL score was the most accurate predictor of both ICU admission and mortality, supporting its usefulness as a prognostic tool in patients with COVID-19. On the other hand, the 4C score demonstrated poor predictive capacity for ICU admission but excellent predictive discrimination for in- hospital mortality, while the NEWS 2 score demonstrated fair predictive capacity for both.