About: A clinical risk score to identify patients with COVID-19 at high risk of critical care admission or death: an observational cohort study.

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About: A clinical risk score to identify patients with COVID-19 at high risk of critical care admission or death: an observational cohort study. Goto Sponge NotDistinct Permalink

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
title	A clinical risk score to identify patients with COVID-19 at high risk of critical care admission or death: an observational cohort study.
Creator	Galloway, James Shah, Ajay Norton, Sam Barker, Richard Brookes Mbchb, Andrew Cantle Msc, Fleur Clarke Msc, Benjamin Mbbch, Raeesa Mbbchir, Russell Mbbs, Carole Phd, Ivana Sneep Msc, Ruth Sugarman Mbbs, Leah Teo Phd, James Williams Msc, Sarah Yates Mbchb, Mark
source	Elsevier; Medline; PMC
abstract	Abstract Background The COVID-19 pandemic continues to escalate. There is urgent need to stratify patients. Understanding risk of deterioration will assist in admission and discharge decisions, and help selection for clinical studies to indicate where risk of therapy-related complications is justified. Methods An observational cohort of patients acutely admitted to two London hospitals with COVID-19 and positive SARS-CoV-2 swab results was assessed. Demographic details, clinical data, comorbidities, blood parameters and chest radiograph severity scores were collected from electronic health records. Endpoints assessed were critical care admission and death. A risk score was developed to predict outcomes. Findings Analyses included 1,157 patients. Older age, male sex, comorbidities, respiratory rate, oxygenation, radiographic severity, higher neutrophils, higher CRP and lower albumin at presentation predicted critical care admission and mortality. Non-white ethnicity predicted critical care admission but not death. Social deprivation was not predictive of outcome. A risk score was developed incorporating twelve characteristics: age>40, male, non-white ethnicity, oxygen saturations<93%, radiological severity score>3, neutrophil count>8.0 x109/L, CRP>40 mg/L, albumin<34 g/L, creatinine>100 µmol/L, diabetes mellitus, hypertension and chronic lung disease. Risk scores of 4 or higher corresponded to a 28-day cumulative incidence of critical care admission or death of 40.7% (95% CI: 37.1 to 44.4), versus 12.4% (95% CI: 8.2 to 16.7) for scores less than 4. Interpretation Our study identified predictors of critical care admission and death in people admitted to hospital with COVID-19. These predictors were incorporated into a risk score that will inform clinical care and stratify patients for clinical trials.
has issue date	2020-05-29(xsd:dateTime)
bibo:doi	10.1016/j.jinf.2020.05.064
bibo:pmid	32479771
has license	els-covid
sha1sum (hex)	871d2cddb3a4ef2476b43e02ed9db3bdd3704bee
schema:url	https://doi.org/10.1016/j.jinf.2020.05.064
resource representing a document's title	A clinical risk score to identify patients with COVID-19 at high risk of critical care admission or death: an observational cohort study.
has PubMed Central identifier	PMC7258846
has PubMed identifier	32479771
schema:publication	J Infect
resource representing a document's body	covid:871d2cddb3a4ef2476b43e02ed9db3bdd3704bee#body_text
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