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Utility of early warning scores to predict mortality in COVID-19 patients: A retrospective observational study

Nidhi Kaeley1, Prakash Mahala1, Ankita Kabi1

  • 1Department of Emergency Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.

International Journal of Critical Illness and Injury Science
|November 11, 2021
PubMed

Insights

Early warning scores (EWS) effectively predict mortality in COVID-19 patients. These scores aid in early severity assessment for better patient outcomes.

Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Public Health

Background:

  • COVID-19 presents with varying severity, posing a global health challenge.
  • While less fatal than SARS-CoV, COVID-19 mortality is higher in older adults and those with comorbidities.
  • Early identification of high-risk patients is crucial for effective management.

Purpose of the Study:

  • To evaluate the predictive utility of various Early Warning Scores (EWS) for mortality in COVID-19 patients.
  • To compare the effectiveness of different EWS in assessing disease severity.
  • To determine if EWS can aid in early risk stratification for COVID-19 patients.

Main Methods:

  • Retrospective study conducted at a tertiary care institute.
  • Collected demographic and clinical data from moderate-to-severe COVID-19 patients.
  • Calculated National Early Warning Score (NEWS), Modified Early Warning Score (MEWS), Rapid Acute Physiology Score (RAPS), Rapid Emergency Medicine Score (REMS), and Worthing Physiological Scoring System (WPS).

Main Results:

  • REMS and WPS demonstrated the highest predictive accuracy for mortality (AUC = 0.892).
  • NEWS showed good predictive value (AUC = 0.813), followed by MEWS (AUC = 0.770) and RAPS (AUC = 0.755).
  • All evaluated EWS showed significant predictive capability for mortality in COVID-19 patients.

Conclusions:

  • Early Warning Scores (EWS) are valuable tools for the early assessment of severity in COVID-19 patients.
  • Triage EWS can reliably predict mortality risk in individuals with COVID-19.
  • Implementing EWS at triage can improve patient management and outcomes.
Abstract

Keywords:
Coronavirus disease 2019early warning scoresintensive care unit mortality

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