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CALL Score and RAS Score as Predictive Models for Coronavirus Disease 2019.

Sultan M Kamran1, Zill-E-Humayun Mirza1, Hussain Abdul Moeed2

  • 1Pulmonology, Pak Emirates Military Hospital, Rawalpindi, PAK.

Cureus
|December 11, 2020
PubMed
Summary

The Comorbidity-Age-Lymphocyte count-Lactate dehydrogenase (CALL) score and the new Respiratory Assessment Scoring (RAS) model effectively predict COVID-19 progression and mortality. Higher scores indicate increased risk for severe disease and death in patients.

Keywords:
a-a gradientcall scorecomorbiditiescovid-19minimal exercise desaturationoxygen saturationprediction modelprognostic markersrespiratory rate

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Area of Science:

  • Pulmonology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Coronavirus disease 2019 (COVID-19) presents significant pulmonary manifestations, necessitating effective prognostic tools.
  • Existing prognostic models for COVID-19 often lack data on key respiratory parameters.
  • There is a need for improved models to guide treatment and resource allocation for COVID-19 patients.

Purpose of the Study:

  • To evaluate the prognostic value of the Comorbidity-Age-Lymphocyte count-Lactate dehydrogenase (CALL) score.
  • To introduce and validate the Respiratory Assessment Scoring (RAS) model for predicting COVID-19 progression and mortality.
  • To identify critical respiratory parameters influencing COVID-19 outcomes.

Main Methods:

  • Retrospective analysis of 252 COVID-19 patients' data from April to August 2020.
  • Calculation of CALL score and RAS model parameters (respiratory rate, oxygen saturation, alveolar-arterial gradient, exercise desaturation) upon admission.
  • Application of univariate and multivariate Cox regression, nomogram creation, and ROC analysis to establish predictive accuracy.

Main Results:

  • The CALL score and RAS model demonstrated strong associations with disease progression and mortality.
  • Elevated respiratory rate (>30 b/m), low resting oxygen saturation (<90%), and high alveolar-arterial oxygen gradient were significant predictors of adverse outcomes.
  • The RAS model achieved an AUROC of 85%, indicating robust predictive performance for disease progression and mortality.

Conclusions:

  • Both CALL and RAS scores are reliable indicators of disease progression and mortality in COVID-19 patients.
  • The RAS model, incorporating key respiratory parameters, offers a valuable tool for risk stratification.
  • These scoring systems can aid in clinical decision-making and patient management for COVID-19.