Validation of a simple risk stratification tool for COVID-19 mortality

Area of Science:

• Clinical Medicine
• Epidemiology
• Biostatistics

Background:

• Risk prediction is crucial for clinical care and resource allocation.
• The COVID-19 pandemic highlighted the need for accurate risk stratification tools.
• A simplified risk score was previously developed in Wuhan, China.

Purpose of the Study:

• To validate a simplified COVID-19 risk stratification score in a larger Austrian patient cohort.
• To assess the score's performance in predicting in-hospital mortality during the pandemic's second wave.

Main Methods:

• Utilized a cohort of 961 COVID-19 patients admitted between June 2020 and March 2021 in Graz, Austria.
• Applied a previously developed point-based score using age, oxygen saturation, C-reactive protein (CRP), and creatinine levels.
• Employed Cox regression to analyze the association between the risk score and 28-day mortality.

Main Results:

• A score above 22 was significantly associated with higher mortality (p < 0.001).
• Each one-point increase in the score correlated with a 1.2-fold increase in 28-day mortality risk.
• High-risk patients (≥22 points) exhibited a 3-4 fold increased mortality risk, confirming score validity.

Conclusions:

• The simplified risk stratification score demonstrates good performance in a separate validation cohort.
• This easy-to-implement tool, using routine parameters, can aid COVID-19 risk stratification.
• Prospective assessment is recommended to evaluate the clinical utility of this risk prediction tool.